腰椎椎弓根延长椎管扩大成形术对椎管影响的解剖学研究

The Anatomy Study of Impact on Spinal Canal Through Lumbar Pedicle Extended Laminoplasty

目的通过经椎弓根截骨延长椎弓根扩大椎管,并应用螺旋CT三维重建测量各节段腰椎截骨椎弓根延长前后椎管面积,为临床进行腰椎管减压提供解剖学依据。方法 10具成人腰椎标本(L_1～L_5),螺旋CT分别对椎弓根截断前后的腰椎标本进行扫描,对CT重建后的图像进行测量,包括原始腰椎各节段椎管面积,椎弓根截断后椎弓根后移2、4、6 mm后的椎管面积。结果对椎弓根截断前后椎管面积进行比较,结果显示,L_1～L_5椎弓根后移4、6 mm,椎弓根截断前后椎管面积对比有统计学差异(P<0.05),L_1～L_3、L_5节段椎弓根后移2 mm,椎弓根截断前后椎管面积对比有统计学差异(P<0.05)。结论经椎弓根截骨椎管扩大成形术,可以明显增加腰椎管的面积,为临床进行腰椎管减压提供一种新的方法。

Objective To explore the variation of L_1 to L_5 spinal canal dimension with the application of spiral three dimentional CT reconstruction after transpedicle osteotomy so as to provide anatomical evidence for lumbar spinal cannal decompression.Method Ten cadaver specimens of adult lumbarsacral spine（L1 to L5） were prepared for spiral three dimentional CT reconstruction before and after pedicle was recected.The CT screenage datas were measured in respect of the spinal canal dimension when pedicle was intact and when disarticulated pedicle was transferred backward at 2 mm,4 mm,and 6 mm distance. Results Compared with the intact spinal canal,there were statistically significant dimension change in L1 to L5 when recected pedicle was transferred backward at 4 mm and 6 mm distance（P〈0.05）,and as well as in L1-3,L5 when disarticulated pedicle was transferred backward at 2 mm distance（P〈0.05）. Conclusion Transpedicle osteotomy increased spinal canal dimension significantly,which will be a new way for lumbar spinal cannal decompression.