腰椎参数测定与腰椎不稳的评估  

The measurement of parameter of lumber and the assessment of lumber instability

作　　者：刘旭[1] 张力[2] 白芃 夏长丽[1] 李幼琼[1] 

机构地区：[1]吉林大学基础医学院人体解剖学系,吉林长春130000 [2]吉林大学中日联谊医院神经内科,吉林长春130000 [3]山西医科大学汾阳学院,山西汾阳032200

出　　处：《解剖学研究》2015年第6期479-482,共4页Anatomy Research

摘　　要：目的测量获得健康人群的腰椎相关参数的诊断参考值范围，并对单纯性腰椎不稳进行评估，为临床诊断腰椎不稳疾患提供参考依据。方法从静态腰椎CT平片入手，分别测量健康人群和腰椎不稳患者的腰椎前凸指数α，L4/L5相对骶骨的距离d1和d2，侧凸指数θ等4个参数，Matlab软件进行统计学分析。结果获得健康成人腰椎仅，ddd2的临床诊断参考值，男性126．784°〈α〈132．304°，66．693mm〈d1〈70．975mm，29．256mm〈d2〈33．472ITlm；女性126．785°〈α〈131．025°，58．322mm〈d1〈63．258mm，27．846mm〈d2〈31．588mm。腰椎不稳时：（1）α增大（2）d1／d2变小。结论可得到腰椎相关参数的临床参考值，对东北地区人群腰椎的健康水平进行评估。其中α，d1／d2对诊断腰椎不稳具有重要临床参考价值。然而是否患者可以省去生理生化复杂检查，仅通过影像学分析对腰椎不稳进行临床诊断仍然值得商榷。Objective To receiving the reference range for healthy people＇ s lumbar parameter which is capable of providing criteria for clinical diagnosis. Methods The author employed CT plain film as a measuring method, respectively measured four relative parameters, including the lordosis index α of healthy people and patients＇ with simple lumbar instability, whether the lumbar exceed the right angle range, the relative distance from L4/L5 to sacrum and lumbar scoliosis index θ. Then utilize Maflab program to cast an statistical analysis. Results This research receive results containing two clinical criteria for diagnosis： and dl/d2. Their reference ranges are： male 126.784°〈α〈132.304°, 66.693 mm〈d/〈70.975 mm, 29.256 ram〈d2〈33.472 mm; female 126.785° 〈α 〈131.025°, 58.322 mm〈d1〈63.258 mm, 27.846 mm〈d2〈31.588 mm. Further assessment for lumbar instability can be approached based on the comparison between the healthy people and patients with simple lumbar instability, these following principle tend to appear on dis- eased individual which is sequentially patent： （1） Marked growth of a （2） Descent of d l/d2 （3） Right angle relationship of lumbar and sacrum remained unchanged. Conclusion These case studies reached the clinical reference value for lumbar, which is able to cast a diagnosis and assessment for lumbar health level of peoples in the northeast China. Impressively, two parameters as α of healthy adults and d1/d2 is vital for the diagnosis of simple lumbar instability which possess high clinical value. However there are also disputable polemic on this analysis simply based on medical image rather than omitting physiological and biochemical examination with huge complexity.

关 键 词：单纯性腰椎不稳 CT平片 前凸指数 侧凸指数 L4/L5相对骶骨的距离 

分 类 号：R322.7[医药卫生—人体解剖和组织胚胎学]