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强直性脊柱炎征象的脊柱标本观察及影像学分析

Observation and imaging analysis of signs of ankylosing spondylitis in spinal specimens
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摘要 目的为强直性脊柱炎的解剖学、影像学和临床诊治及脊柱外科手术提供参考。方法采用脊柱非测量观察、X线检查和脊柱测量2具脊柱标本,并进行数字图像采集和处理。结果第1例标本为第7胸椎(T_(7))~第3腰椎(L_(3)),全长29.7 cm;第2例标本为第7颈椎(C_(7))~第2腰椎(L_(2)),全长38.3 cm。标本中韧带部分或完全钙化,小关节、椎间盘骨化,骨质疏松;椎间孔的前后径(宽度)比正常成人窄,大多数上下径(高度)较宽。影像上标本前纵韧带钙化呈点状或条纹状,但实际标本呈片状。标本可呈现X线二维平面难以表现的关节突关节、肋椎关节、椎间孔等。结论随着强直性脊柱炎病情进展,患者脊柱弯曲、旋转等活动范围减小,胸廓扩张程度减小,进而影响呼吸,且难以进行椎管内麻醉和骶管注射等操作。在诊断方面,通过骨骼标本和X线影像,我们可以更直观、准确地了解强直性脊柱炎的发展过程和严重程度。 Objective To provide anatomical,radiological,and clinical diagnostic and therapeutic references for ankylosing spondylitis and spinal surgical operations.Methods Non-measurement spinal observations,X-ray examinations,and measurements were performed on two spinal specimens,along with digital image acquisition and processing.Results The first specimen included thoracic vertebra 7(T_(7))to lumbar vertebra 3(L_(3)),with an average total length of 29.7 cm;the second specimen ranged from cervical vertebra 7(C_(7))to lumbar vertebra 2(L_(2)),with an average total length of 38.3 cm.The specimens showed partial or complete calcification of ligaments,ossification of the small joints and intervertebral discs,and osteoporosis;The anterior-posterior diameter(width)of the vertebral foramen was narrower than that of a normal adult,while most of the superior-inferior diameter(height)was wider.Radiographically,the anterior longitudinal ligament calcification appeared as dot-like or striated,but it was actually flaky in the actual specimens.The specimens provided views of the facet joints,costovertebral joints,and intervertebral foramina that was difficult to demonstrate on two-dimensional X-ray images.Conclusion As ankylosing spondylitis progresses,the range of motion in spinal bending and rotation decreases,as does the extent of thoracic expansion,thereby affecting respiration and complicating procedures such as intraspinal anesthesia and sacral canal injections.In terms of diagnosis,bone specimens and X-ray films allow us to understand the development process and severity of ankylosing spondylitis more directly and accurately.
作者 钟伟兴 王志宏 李俊桦 廖立青 谌祖江 李义凯 ZHONG Wei-xing;WANG Zhi-hong;LI Jun-hua;LIAO Li-qing;CHEN Zu-jiang;LI Yi-kai(Department of Acupuncture,Massage and Orthopedics and Traumatology,School of Traditional Chinese Medicine,Southern Medical University,Guangzhou 510515,China;Department of Orthopedics and Traumatology of TCM,Center for Orthopacdic,the Third Affiliated Hospital,Southern Medical University,Guangzhou 510630,China;Department of Radiology,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China)
出处 《解剖学报》 CAS CSCD 2024年第3期329-333,共5页 Acta Anatomica Sinica
基金 国家自然科学基金(82274669) 广东省教育厅广东省普通高校重点科研平台项目(粤教科函〔2022〕4号2022ZDZX3004) 南方医科大学第三附属医院院长基金(YP202210) 深圳市“医疗卫生三名工程”项目(深卫健中医〔2021〕6号SZZYSM202108013)。
关键词 强直性脊柱炎 脊柱 骨骼标本 X线 影像解剖学 Ankylosing spondylitis Spine Skeletal specimen X ray Imaging anatomy Human
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