腰椎椎间关节滑膜皱襞的解剖学研究及成人儿童的比较

Anatomical observation and clinical significance of synovial folds of lumbar zygapophyseal joints

目的:研究腰椎椎间关节滑膜皱襞的解剖学组织结构,探讨其临床价值。方法:对24具成人腰椎脊柱标本和40具儿童腰椎脊柱标本的解剖,观测腰椎间关节内滑膜皱襞的结构。结果:无论成人还是儿童,各腰椎间关节均可出现滑膜皱襞。两者比较,成人滑膜皱襞的出现率为85.9%高于儿童(35.9%),且成人以大中型滑膜皱襞为主,而儿童以小型为主。成人滑膜皱襞主要出现在外上(14.6%)、外下(16.6%)及外侧(17%),而儿童主要出现在上(20.3%)、下缘(27.1%),成人与儿童的滑膜皱襞的形态均以片状为主。结论:成人腰椎椎间关节滑膜皱襞的出现率高,以大中型滑膜皱襞为主,这很可能是腰椎椎间关节滑膜皱襞嵌顿多见于成人,而儿童少见的解剖学基础,也可能是成人较儿童腰背痛多见的原因之一。

Objective： To explore the anatomic and histological features of synovial folds of lumbar zygapophyseal joints and determine its clinical significance. Methods： Lumbar zypophyseal joints from 40 embalmed children cadavers and 24 adult cadavers were dissected and observed. Results： Synovial folds could be found in both adults and children. Comparing with the child group, the adult group had a higher occurrence rate（85.9% ）than that（35.9% ）of child group. The synovial folds in adult were medium or large sizes, however those in child were small size. The synovial folds in adult located mainly at the superior-lateral （ 14.6% ）, inferior-medial （ 16.6% ） and lateral （ 17% ）direction, but those of child were at superior （20.3%）or inferior （27. 1% ）direction. The shape of the synovial folds was flake mostly. Conclusions： It is suggested that synovial folds of the lumbar zygapophyseal joints are bigger for adults than for children. This may be the reason why some low back pain easy to take place in adults rather than in children.