腰椎椎板下棘的影像学表现及其形成机制的探讨

Exploration on the imaging manifestations and formation mechanism of spine lamina vertebrae inferior of lumbar spine

目的探讨腰椎椎板下棘的影像学表现及其形成机制。方法选取2018年1月~2018年5月于我院对脊椎进行CT检查的患者400例,比较不同年龄段稳定性脊柱(对照组)与不稳定性脊柱(观察组)椎板下棘的发生率,比较不同脊柱节段椎板下棘的发生率。观察椎板下棘的形态及其与椎间黄韧带的毗邻关系。结果椎板下棘主要发生于中老年患者,年龄越大,椎板下棘的发生率越大(P<0.05);椎板下棘均出现于T11~L5,出现率较高段为T 11、T12、L1及L5处;脊柱不稳定组椎板下棘的发生率显著高于脊柱稳定组(P<0.05);椎板下棘的边缘位置与椎间黄韧带外侧缘相一致。结论通过对脊椎进行CT冠状位、矢状位及斜位重建及三维图像重组,可以清楚的观察到椎板下棘的形态及其与椎间黄韧带的毗邻关系;椎板下棘的形成可能与脊椎的退行性变、脊柱的应力作用以及韧带骨化及受力有关。

Objective To explore the imaging manifestations and formation mechanism of sublaminar spine of lumbar spine.Methods 400 patients,who were subjected to spinal CT inspection in our hospital from January 1,2018 to May 30,2018,were selected in this work.The incidence of spine lamina vertebrae inferior on the stable the spine(control group)and unstable spine(observation group)in different ages was compared and the incidence of spine lamina vertebrae inferior under different spinal segments was also compared.The coronal,sagittal,oblique and three-dimensional reconstruction of CT images on all patients were performed to observe the morphology of sublaminar spine and the imaging manifestations of the adjacent relation to the intervertebral yellow ligament,and then the formation mechanism of sublaminar spine of lumbar spine was discussed.Results Sublaminar spine mainly occurred in middle-aged and elderly patients.The higher the age,the higher the incidence of sublaminar spine(P<0.05).Sublaminar spine appeared in t 11~l5,with higher occurrence rates of T11,T12,L1 and L5.The incidence of sublaminar spine in the unstable spine was significantly higher than that in the stable spine(P<0.05).Conclusion The morphology of vertebral sublaminar spine and its adjacent relation to the intervertebral yellow ligament can be clearly observed through CT coronal,sagittal and oblique reconstruction and three-dimensional image reconstruction of the spine.The mechanism underlying the formation of vertebral sublaminar spine may be related to the degenerative changes of the spine,the stress action of the spine,and the ossification and stress of ligaments.