腰椎侧隐窝和脊神经根的观测及临床意义

The survey on lumbar lateral recessus and spinal nerve root and its clinical significance

目的:研究腰椎侧隐窝的形态特点及脊神经根占位,探讨其临床意义。方法:用35套腰椎骨性标本、23例脊柱腰段断层标本和50例腰椎CT片,观察侧隐窝的形态特点,测量侧隐窝矢径及脊神经根直径,骨性标本和断层标本用游标卡尺测量,CT片用"eFilm workstationTM2.0"软件测量,结果经统计学处理。结果:(1)L3～5形成明显的侧隐窝,其侧隐窝分为上、下两部分,上部入口矢径D1分别为:(8.92±0.86)、(8.55±1.25)、(8.23±1.14)mm,下部上缘入口矢径D2分别为(:11.29±1.34)、(10.18±1.31)、(9.84±1.11)mm;(2)断层标本L3～5侧隐窝入口矢径d1分别为:(5.73±1.89)、(5.34±1.18)、(5.08±0.81)mm,脊神经直径d2为(4.17±0.41)、(4.43±0.47)、(4.62±0.56)mm;(3)CT测量L3～5侧隐窝入口矢径分别为:(5.69±1.36)、(5.42±0.89)、(5.18±1.07)mm,脊神经直径分别为:(4.02±0.74)、(4.36±0.78)、(4.61±0.56)mm。结论:L3～5腰椎侧隐窝由上至下逐渐明显,侧隐窝矢径逐渐减小,脊神经根直径逐渐增大。L3～5侧隐窝分为上、下两部分,其下部的构成特点易因病理改变而引起狭窄。

Objective：To study morphologic features of lumbar lateral recessus and spinal nerve root and explore its clinical significance. Methods： Morphologic characteristics and sagittal diameters of lambar lateral recessus, and the diameters of lumbar spinal nerve root were observed and measured on 35 sets of lumbar specimens, 23 cases of transverse section specimen of lumbar spine and 50 cases of lumbar CT images. The vernier caliper and the software of the“eFilm workstation TM2.0”were used for specimen and image analysis respectively, and the results were handled statisticly. Results： （1） Lateral recessus formed at the sides of L3-s spine, which included the upper and lower parts. The sagital diameters of the upper parts of lateral recessus （D1） for L3-5 vertebrae were （8.92±0.86）,（8.55±1.25 ） and（ 8.23±l.14）mm,and those of the lower part （D2） （ 11.29± 1.34 ）, （ 10. 18± 1.31 ） and（ 9.84±1.11 ）mm respectively; （ 2 ）For transverse section specimens, D1 were （5.73±1.89）,（5.34±1.18） and （5.08±0.81）mm, the diameters of spinal nerve root nerve （4.17±0.41）,（4.43± 0.47 ） and（ 4.62±0.56 ）mm respectively; （ 3 ）For CT images, D 1 were （ 5.69±1.36 ）, （ 5.42±0.89 ） and（ 5.18±1,07 ） ram, and the diameters of spinal nerve root （4.02±0.74）,（4.36±0.78） and （ 4.61±0.56）mm respectively. Conclusions：The sagital diameters of latreal recessus is gradually decreased from up to down, while the diameter of spinal nerve root increased. Lumbar lateral recessus can be divided into upper and lower parts, and the narrow appeared mainly at the lower part for its anatomic features.