腰骶移行椎椎体及椎板的形态学特点及临床意义

The morphology of the vertebral body and lamina of the lumbosacral transitional vertebrae and its clinical significance

目的:研究腰骶移行椎椎体及椎板的形态学特点,为临床诊治疗提供依据。方法:对91例腰骶移行椎椎体上面矢状径/横径,椎体前高/后高,上关节突关节面的矢状径、横径及其与正中矢状面夹角等进行测量。结果:腰骶移行椎椎体上面矢状径与横径比为0.64,前/后比为1.21。上关节突关节面高度,左(14.1±2.1)mm,右(13.9±1.5)mm;宽度,左(16.0±1.8)mm,右(16.2±1.5)mm;与正中矢状面夹角,左(56.3°±7.8°),右(55.9°±7.3°)。结论:(1)腰骶移行椎椎体的形态与正常L5椎体形态相近,故在腰椎正侧位片及CT、MRI片难以根据其椎体形态学特点推断是否为移行椎,后路手术时很难根据椎板及棘突上关节突的形态特点来判断腰骶移行椎。(2)腰骶移行椎的下关节突明显小于上关节突,说明小关节突很少或几乎不向下传导应力。

Objective：To study the morphology of the vertebrae body and lamina of the lumbosacral transitional vertebrae and provide basis for clinical application. Methods： 91 dry lumbosacral transitional vertebrae specimen were anatomically evaluated, the anterior body height, the posterior body height, the diameters of the superior articular process, the oblique angle of the plane of the thickness, the height of the lamina at the middle site were measured with the caliper and protractor in all specimens. Results： The sagittal diameter of the upper endplate was （ 32.3±2.9 ）mm, and transverse diameter （ 50.6±4.5 ）mm. The anterior body height was （27.7±2.1）mm,and the posterior body height （22.9±2.0）mm. The height of the superior articular process was （ 14.1±2,1 ）mm in the left,and 13.9±1.5mm in the right. The width of it was （ 16.0±1.8）mm in the left, （16.2±1.5）mm in the right. The angle slant was 56.3°±7.8° in the left and 55.9°±7.3° （40°-70° ） in the fight. The height of the inferior articular process was （ 10.4±2.1 ）mm in the left and （ 10.2±2.7 ）mm in the right. The width of it was （8.9±2.3）mm in the left,and （8.8±2.4）mm in the right. The height of the lamina at the middle site was （16.7±2.30mm in the left and （17.3 ±2.50mm in the right. The thickness of the lamina was （6.2±1.2）mm in the left and （6.1 ±1.1 ）mm in the right. Conclusions： The morphology of the lumbosacral transitional vertebrae is similar to that of L5 in normal, so it is difficult to diagnose the transition vertebrae in MRI, CT and X-ray film according to its body morphology. The superior and inferior articular processes are also similar to that of L5 in normal, but the inferior articular process is obviously smaller than that of the superior one, which is the reason of the abnormal stress on lumbosacral transitional vertebrae.