椎下切迹的测量分析对经椎间孔入路的脊柱内镜技术的意义  

The Significance of the Inferior Vertebral Incisure Analysis on the Transformational Spinal Endoscopy Technique

作　　者：甄瑞鑫[1] 李玉波[1] 宋有鑫[1] 安永胜[1] 陈宾[1] 

机构地区：[1]承德医学院附属医院脊柱外二科,河北承德067000

出　　处：《实用骨科杂志》2017年第10期879-883,共5页Journal of Practical Orthopaedics

基　　金：河北省2015年度医学科学研究重点课题(20150419)

摘　　要：目的明确出行神经根在椎体下切迹内走行区域对实施经椎间孔脊柱内镜技术的意义。方法以25~35岁,45~55岁,65~75岁年龄段分为A、B、C三组,每组随机抽取40例,共120例,男女比例1︰1。通过观察腰椎侧位X线片、腰椎MRI等常规术前影像学资料,描述L_(3~4)、L_(4~5)、L_5S_1椎间孔结构与神经根的空间几何关系;测量椎下切迹高度、宽度,用以描述椎下切迹随椎间孔退变的特征变化,并通过SPSS 19.0进行单因素方差分析。结果共观测720个椎间孔,每个年龄组240个。神经根在下腰椎椎间孔内走行于椎体下切迹内。测得椎下切迹宽度均值A组(1.5146±0.0138)mm,B组(1.4933±0.0190)mm,C组(1.4875±0.0184)mm;测得椎下切迹高度均值A组(1.016 7±0.028 7)mm,B组(0.884 2±0.014 05)mm,C组(0.993 8±0.015 05)mm。单因素方差分析结果椎下切迹宽度各年龄组测量值差异无统计学意义(P=0.071);椎体下切迹高度各年龄组测量值差异有统计学意义(P=0.000)。结论术前影像学分析神经根在椎下切迹的走行部位,可以为经椎间孔脊柱内镜技术提供避免损伤出口神经根的影像学参考。Objective To study the division of the travel nerve root in the inferior vertebral incisure in order to guide the implementation of the spinal endoscopic technique via the intervertebral foramen.Methods Three groups（A,B,C）were divided by the age：25~35 years old,45~55 years old,and 65~75 years old.Each group were randomly selected40 people,with a total of 120 people and the ratio of male and female 1︰1.Describe the spatial geometric relationships between L3~4,L4~5,L5 S1 intervertebral foramen structures and nerve roots by observing the lumbar lateral position Xray,lumbar MRI and other conventional preoperative imaging data.Measure the height and width of the Inferior vertebral incisure and analyze the testing data in SPSS 19.0 by using one-way analysis of variance.Results A total of 720 intervertebral foramen were observed,with 240 in each group.Nerve roots within the Intervertebral foramen direction in the Inferior vertebral incisure.The mean value of the width of the measured inferior vertebral incisure is： Group A（1.514 6±0.013 8）mm;Group B（1.493 3±0.019 0）mm;Group C（1.487 5±0.018 4）mm.The mean value of the height is：Group A（1.016 7±0.028 7）mm;Group B（0.884 2±0.014 05）mm;Group C（0.993 8±0.015 05）mm.The one-way ANOVA results showed：there was no significant difference between the measured values of the inferior vertebral incisure width in each group（P=0.071）,while the differences of the（measured values of the inferior vertebral incisure）height in each group was statistically significant（P=0.000）.Conclusion Preoperative imaging analysis of nerve root in vertebral incised trace of course place,can offer the reference for the Transformational spinal endoscopy technique to avoid damage nerve root imaging.

关 键 词：内窥镜 椎下切迹 神经根 椎间孔影像学 

分 类 号：R681.53[医药卫生—骨科学]