非侵入性腰椎屈伸运动的动态观察

NONINVASIVE DYNAMIC EXAMINATION IN MOTION OF FLEXIONEXTENSION OF LUMBAR SPINE

本研究应用电视X线动态摄影和计算机图形重建技术,建立了数字化X线电视分析系统,可对脊柱的总体和各活动节段作非侵入性动态观检。通过对44例正常人腰椎主动屈伸运动测定,取得一组正常参数值。并将本法试用于21例腰腿痛患者。结果表明:腰椎屈伸活动时,L_(1～2)角活动度和平移量最小,分别为12.57°和2.1mm;L_(4～5)角活动度和平移量最大,分别为18.42°和3.7mm。正常人腰椎各节段屈曲活动度和平移量比伸直活动时大,每5～6°屈伸活动伴有1mm平移。正常人男、女之间在屈伸活动时,各节段活动度和平移量无显著性差异(P>0.05);正常人各年龄组之间的活动度和平移量无显著性差异(P>0.05)。本法在精度、可重复性、无创伤性、可分节段性检测和可发现一些“潜在”运动学异常等方面具有独特优点,有较大的研究和临床应用价值。

Dynamic vidio-radiography and computer-assisted method in reconstructing figure were used in this study and a new noninvasive method of digital-vidio-fluoroscopic system had been established for dynamic examination of the whole spine and every motional unit. Through examination of forty - four healthy adults by means of dynamic radiographs during active flexion-extension, a set of normal parameter of performed segmental motions and translations was obtained. This method was also used in twenty-one patients with low back pain. Results indicate that in flexion - extension motion, the motion in angles and translations at L1～2 level was the smallest, 12.17° and 2.1mm, and that at L4～5 level was the largest, 18.42° and 3.7mm. There was 1mm translation at every 5 to 6 degrees angulatory motion. Three was no significant in crease or decrease in either angulatory or translational motions with a change in age group at any leval. No statistically significant difference in angulatory and translational motions could be found at any lavel between men and women. These results showed that this method is unique in its advantages of being accurate, repeatable, non-injurious and can be used in separate motional segment. This methed can also reveal some abnormal motions that can not be found in routine radiographs. It is therefore valuable in research as well as in clincal pratice.