腰神经后支影像解剖学定位研究及其意义

The diagnosis and treatment of the syndrome of lumbar spinal nerve posterior rami:imaging anatomic study

目的为诊治腰背部疼痛及麻醉定位提供腰神经后支的影像解剖学资料。方法选择符合实验要求成年30例,行螺旋CT薄层扫描(范围T12-S1),将原始数据导入重建软件进行相关指标测量,并行统计分析。结果横突根点旁开距离L1-L5分别为(20.86±6.00)mm,(21.19±4.71)mm,(22.86±4.53)mm,(24.56±5.10)mm,(26.68±5.98)mm;横突根点深L1-L5分别为(27.55±4.42)mm,(29.02±5.39)mm,(32.64±5.03)mm,(33.92±4.74)mm,(35.65±4.89)mm;横突根点高L1-L5分别为(8.12±5.84)mm,(8.22±4.87)mm,(8.61±4.60)mm,(8.40±6.13)mm,(8.49±4.67)mm;L1-L5横突、横突根点旁开距离及深度等观测指标均有明显的变化规律。结论三维重建,可真实客观地反映各腰椎相关结构指标和变化规律,为腰段麻醉定位、腰背痛疾患诊治提供影像解剖学依据。

Objective To provide imaging anatomic data of lumbar spinal nerve posterior rami for diagnosing and treating lumber and back pain and confirming the local anesthesia points.Methods 30 adult volunteers were taken as the subjects.Multi-slice spiral CT scans（T12-S1） was performed,and then the data were analyzed and 3D reconstructed by Mimics software.Results The left and right distances of transverse root point from L1 to L5 were（20.86±6.00）mm,（21.19±4.71）mm,（22.86±4.53）mm,（24.56±5.10）mm and（26.68±5.98）mm,as well the depth of transverse root point from L1 to L5 were（27.55±4.42）mm,（29.02±5.39）mm,（32.64±5.03）mm,（33.92±4.74）mm,and（35.65±4.89）mm respectively,and the height of transverse root points were（8.12±5.84）mm,（8.22±4.87）mm,（8.61±4.60）mm,（8.40±6.13）mm and（8.49±4.67）mm respectively.There was significant difference of the length,thickness and height of L1~L5 transverse processus between the gender and the bilateral sides.Conclusions Anatomic features and diversities of lumber vertebra and adjacent structures can be presented by three-dimensional reconstruction skill,which is valuable for the diagnosis and treatment of the lumbodorsal diseases.