腰椎解剖结构年龄差异性的研究及其临床意义

Study on the age difference of lumbar spine anatomy and its clinical significance

目的测量与探讨不同年龄段腰椎解剖结构指标差异,以期为临床诊治不同年龄段腰椎病变提供相关解剖学参数。方法选取成人腰椎解剖结构的核磁图像300例,男、女各150例,分青年、中年、老年3个年龄组,以腰椎椎体+椎间盘的高度、椎间孔上下径和前后径、神经根至椎弓根距离等为观察指标,数据采用SPSS 22.0统计软件进行分析,组间比较采用LSD-t检验,以P<0.05为差异有统计学意义。结果(1)椎体+椎间盘的高度:女性L2、男性L5中、老年组之间差异无统计学意义(P>0.05),其他各组之间差异均有统计学意义(P<0.05)。(2)椎间孔上下径:女性左侧L5~S1青、中年组之间、男性左侧L4~5中、老年之间差异无统计学意义(P>0.05),其他各同序号腰椎同侧椎间孔上下径之间差异均有统计学意义(P<0.05)。(3)椎间孔前后径:女性青、老年组间L4~S5、L5~S1和中、老年组间右侧L5~S1,男性青、老年组间右侧L1~2、左侧L2~3和中、老年组间左侧L2~3,差异均有统计学意义(P<0.05)。(4)神经根至椎弓根距离:女性中、老年组与青年组比较,各同序号腰椎同侧差异均有统计学意义(P<0.05),中、老年组比较,左、右侧L2和左侧L3、L4,差异均有统计学意义(P<0.05);男性青、中年组比较,左侧L1和左、右侧L3,差异均有统计学意义(P<0.05);青、老年组比较,除右侧L5差异无统计学意义(P>0.05)外,其他差异均有统计学意义(P<0.05);中、老年组比较,除左、右侧L5差异无统计学意义(P>0.05)外,其他差异均有统计学意义(P<0.05)。结论不同年龄组腰椎结构指标存在的差异,对诊治不同年龄段的腰椎疾病具有临床指导意义。

Objective To measure and explore the differences in the anatomical structure of lumbar spine at different ages,in order to provide relevant anatomical parameters for clinical diagnosis and treatment of lumbar spine diseases at different ages.Methods 300 MRI images of adult lumbar spine anatomy were selected,150 males and 150 females,divided into three age groups:young,middle-aged,and old group.The height of lumbar vertebral body+intervertebral disc,the upper and lower diameters of the foramen,the anteroposterior diameter of the foramen,and the distance from the nerve root to the pedicle were the observation indicators.The data was analyzed by SPSS 22.0 statistical software.The comparison between groups was performed by LSD-t test,and P<0.05 was considered statistically significant.Results(1)The height of the vertebral body+intervertebral disc:P>0.05 between the female L2 middle-aged and old group,the male L5 middle-aged and old group,P<0.05 among the other groups.(2)The upper and lower diameter of the intervertebral foramina:except for women’s left L5-S1 between young and middle-aged group,and men’s left L4~5 between old and middle-aged group,P>0.05,all other P<0.05 between the lumbar intervertebral foramina with the same serial number and the same side.(3)The anteroposterior diameter of the intervertebral foramina:L4-S5,L5-S1 between female young and old group,right L5-S1 between female middle-aged and old group,right L1~2,left L2~3 between male young and old group,left L2~3 between male middle-aged and old group,all P<0.05.(4)Distance from nerve root to pedicle:(1)Female:Comparison of middle-aged,old with young group,each with the same serial number on the same side of the lumbar spine P<0.05;comparison of middle-aged and old group,left and right L2,left L3 and L4,all P<0.05;(2)Male:Comparison of young and middle-aged group,L1 on the left and L3 on the left and right sides,P<0.05;Comparison of young and old group,except for the right L5 P>0.05,all others were P<0.05;Comparing the middle-aged and old group,except for the left and right L5 P>0.05,the others were all P<0.05.Conclusion There are differences in lumbar spine structural indicators in different age groups,which have clinical guiding significance for the diagnosis and treatment of lumbar spine diseases of different age groups.