成人下腰椎终板矢状面形态的CT测量  

CT measurement of sagittal endplate morphology of the adult lower lumbar spine

作　　者：孙文志[1] 鲁世保[1] 海涌[1] 藏磊[1] 康南[1] 孟祥龙[1] 王宇[1] 刘铁[1] 

机构地区：[1]首都医科大学附属北京朝阳医院骨科,100020

出　　处：《中华骨科杂志》2015年第12期1222-1227,共6页Chinese Journal of Orthopaedics

摘　　要：目的通过CTN量分析成人下腰椎L3～S1终板的矢状面形态学特征，探讨其在腰椎人工椎间盘及椎间融合器形态设计中的意义。方法招募80名健康成年志愿者，行腰椎CT扫描及矢状面重建。于正中矢状面上测量L，下终板至S，上终板矢状面凹陷角、终板凹陷区域位置及终板凹陷区域最凹点深度。根据患者年龄（〉40或≤40岁）及性别将cT图像分为四组，将终板矢状面形状分为平坦型、均匀凹陷型及非均匀凹陷型。比较不同年龄及性别组的终板形态分型、终板矢状面凹陷角及最凹点深度，不同终板形态分型组的凹陷区域位置，同一椎体上下终板、同一椎间隙相邻终板的最凹点深度。结果各年龄及性别组间下腰椎终板矢状面形状的差异均无统计学意义。L3下及L5上、下均匀凹陷型终板最凹点位置（分别为54．61％±7．37％、52．96％±5．51％、57．93％±4．55％）与非均匀凹陷型终板（分别为66．75％±12．13％、67．96％±12．42％、64．31％±9．73％）的差异有统计学意义，其余节段差异均无统计学意义。≤40岁男性与≤40岁女性L5，上终板最凹点深度分别为（2．81±0．99）mm、（1．96±0．69）mm，差异有统计学意义，其余各组差异均无统计学意义。L4,L5椎体下终板凹陷区域最凹点深度较上终板大，L3，4、L4,5、L5S1椎间隙上椎体下终板凹陷区域最凹点深度较下椎体上终板小，差异均有统计学意义。不同性别、不同年龄各节段终板矢状面凹陷角的差异均无统计学意义。结论下腰椎终板除S1上终板外，大部分为凹陷型，终板凹陷多位于终板中后缘。年龄、性别对终板矢状面最凹点深度有一定影响，而对矢状面形状及凹陷角无影响。Objective To measure the sagittal endplate morphology parameters of the adult lower lumbar spine （L3-S1） and to explore its significance in the design and modification of the artificial intervertebral disc and interbody fusion cage. Methods Three-dimensional CT reconstructions of the lumbar were obtained in 80 healthy adult volunteers. Sagittal concavity angle （SCA）, endplate concavity apex （ECA） and endplate concavity depth （ECD） of the L3 inferior endplate to S1 superior endplate in the midsagittal plane were measured. According to the age （〉40 years or ≤40 years） and gender, we divided all the CT images into four groups. The sagittal shapes of the endplate were divided into flat, oblong and ex-centric at the same time. The sagittal shapes of the endplate, the endplate SCA and ECD, the ECA of oblong and ex-centric endplates among different groups, the inferior and superior endplate of the same vertebral and the adjacent endplate ECD of the same segment were measured and compared. Re- suits A sex- or age-related difference could not be found among the sagittal shapes of the endplate. The locations of oblong ECA were only found different between the ones of ex-centric endplates in the superior endplate of L3, the superior and inferior endplate of L. The difference between ECD of superior endplate of L5 in men less than forty years old and women less than forty years old was significant. The inferior endplate ECD was always larger than the superior endplate ECD in the same vertebral （L, Ls）. In each segment （L3,4, L4,5, L5S1）, ECD was smaller in the inferior endplate of the superior vertebra than in the superior endplate of the inferior vertebra （P 〈 0.05）. Conclusion Most of the endplates of the lower lumbar spine are concave besides the superior endplate of S1. And the location of concave endplate ECA is always found in the posterior half of the lumbar endplates. Age and gender have certain effect on the sagittal ECD, but not on sagittal shapes or ECA.

关 键 词：成年人 腰椎 体层摄影术 X线计算机 

分 类 号：R681.53[医药卫生—骨科学]