下腰椎椎板、关节突的影像学测量与临床意义

Imageology of the laminar and articular process of low lumbar laminar and its clinic significance

目的:为腰椎椎板、关节突螺钉瞄准器的设计及临床应用提供影像学基础。方法:测量30例腰痛患者的腰椎X线正位片及下腰椎椎板、关节突CT平扫片,获得椎板、关节突钉道长度、椎板厚度、椎板外斜角及椎板下倾角的相关数据。结果:下腰椎椎板、关节突钉道长度(cm):L3/4男性为(4.63±0.75),女性为(4.40±0.63),L4/5男性为(5.12±0.45),女性为(5.03±0.39),L5/S1男性为(5.47±0.65),女性为(5.35±0.57),钉道长度自L3/4至L5/S1逐渐增大,且测量数据男性较女性长,有统计学意义。椎板厚度(mm):L3男性为(5.4±0.8),女性为(5.2±0.73),L4男性为(6.7±1.4),女性为(6.4±1.5),L5男性为(6.4±1.4),女性为(6.2±1.45),椎板厚度L4较L3厚,L5较L4薄,男性较女性厚,有统计学意义。椎板外斜角(°):L3/4男性为(46±5.1),女性为(45±4.8),L4/5男性为(43±3.8),女性为(44±4.1),L5/S1男性为(36±3.5),女性为(35±3.0),椎板外斜角自L3/4至L5/S1逐渐减小,男性与女性之间无统计学意义上的差异。椎板下倾角(°):L3/4男性为(49±3.6),女性为(48±3.0),L4/5男性为(47±3.1),女性为(48±2.2),L5/S1男性为(51±2.5),女性为(50±1.8),椎板下倾角L4/5较L3/4小,L5/S1较L4/5大,男、女性之间无统计学差异。结论:通过测量患者影像学资料可获得个体化的下腰椎椎板、关节突螺钉应用的相关数据。在此基础上,设计和应用腰椎椎板、关节突螺钉瞄准器具有可行性。

Obeetive： To provide imageologic data for the design of the gunsight of lumbar plate and articular process. Methods： The screw path length of the laminar and articular process, the thickness, lateral-oblique angle and inferior-oblique angle of the laminar were measured with lumbar X-ray and CT on 30 cases suffered from back pain. Results： The screw path length of the laminar and articular process increased gradually from L3/4 to L5S1, which were （4.63±0.75）cm, （4.40±0.63）cm, （5.12±0.45）cm, （5.03±0.39）cm, （5.47± 0.65）cm and （5.35±0.57）cm at the levels of L3/4, L4/5 L5S1 for male and female respectively. Laminar thickness of L4 was greater than that of L3 and L5, which were （5.4±0.8）mm, （5.2±0.73）mm, （6.7±1.4）mm, （6.4±1.5）mm, （6.4±1.4）mm and （6.2±1.45）mm at the levels of L3, L4 and L5 for male and female respectively. Laminar lateral-oblique angle decreased gradually from L3/4 to L5/S1, which were （45_±4.8）°, （43±3.8）°, （44±4.1）°, （36±3.5）°and （35±3.0）°at the levels of L3,4, L4/5, L5/S1for male and female respectively. Laminar inferior-oblique angle of L3/4 was bigger than that of L4/5 and L5/S1, which were （49±3.6）°, （483.0）°, （47±3.1）°, （48±2.2）°, （51±2.5）°and （50±l.8）°at the levels of L3/4, L4/5and L5/S1 for male and female respectively. Conclusions： Individual data of laminar and articule process of low lulmbar could be obtained by imageologic detection, which is a base for designing gnnsight of lumbar plate and articular process.