腰椎间盘镜术定位相关的国人腰椎管CT测量

CT MEASUREMENTS OF LOW LUMBAR SPINAL CANAL IN CHINESE ASSOCIATED WITH THE ORIENTATION IN MICROENDOSCOPY DISCECTOMY

目的:测量L4、L5腰椎管横径及棘突中线至侧隐窝的距离,以确定国人椎板间隙途径腰椎间盘镜穿刺点的解剖学依据。方法:应用CT测量成年男、女各25例L4、L5椎体下缘水平腰椎管横径及棘突中线至侧隐窝的距离,分别计算男、女两组间数据的均数、标准差;分析两组间的统计学差别。结果:男、女两组在L4、L5腰椎管横径及棘突中线至侧隐窝的距离间差异无统计学意义(P>0.05)。男、女两组合并,L4、L5腰椎管横径测量结果分别为(21.82±1.59)mm、(24.68±1.72)mm;L4、L5棘突中线至侧隐窝的距离分别为(10.91±0.79)mm(、12.31±0.84)mm。结论:国人下腰椎椎管测量值有别于其他人种,国人椎板间隙途径腰椎间盘镜穿刺点应为棘突中线旁10 mm。

Objective： To investigate transverse diameter of the lumbar spinal canal and the diameter from median spinous process line to later recess of L4 and L5 on CT images in order to provide anatomical data for puncturing orientation in microendoscopy discectomy. Methods： 50 muhislice spiral CT scanning images of 25 male and 25 female adult Chinese subjects were selected as samples. Transverse diameters of the lumbar spinal canal and the diameters from median spinous process line to lateral recess on L4 and L5 were measured at level of vertebral inferior margin. Statistical analyses were performed to determine mean and standard deviation of two groups and statistically significant difference of two groups were analyzed by using t test. Result：There was no significant difference between the data of male and female groups （ P〉0.05）. The transverse diameters of the lumbar spinal canal on L4 and L5 were （21.82±1.59） mm, （24. 68±1.72） mm respectively. The diameters from median spinous process line to lateral recess on L4 and L5 were（ 10.91 ± 0. 79） mm, （12.31±0.84） mm respectively. Conclusion：The lumbar spinal canal data of Chinese differ from those of other races. The accurate puncturing orientation in microendoscopy discectomy for Chinese should be 10 mm apart from median spinous process line.