旋转腰椎棘突与中心轴线的位置关系  

The Relationship between Spinous Process and Central Axis of Rotated Lumbar Spine

作　　者：吴科[1] 韩同坤 俞家福 WU Ke;HAN Tongkun;YU Jiafu(Songgang People＇s Hospital of Shenzhen,Shenzhen 518105,Guangdong China.)

机构地区：[1]广东深圳市宝安区松岗人民医院,广东深圳518105

出　　处：《中国中医骨伤科杂志》2018年第11期25-28,共4页Chinese Journal of Traditional Medical Traumatology & Orthopedics

摘　　要：目的:明确旋转腰椎棘突和中心轴线的关系,以期探讨"棘突偏歪"在"骨错缝"诊断和治疗上的意义。方法:选择2017年6月至2018年6月在本科诊断为腰椎后关节错缝症的500例,按照NashMoe法取椎体旋转度评价为+级的腰椎正位X线片,观测旋转腰椎棘突和腰椎中心轴线的位置关系。结果:500例腰椎正位X片上,共有旋转腰椎1 238个,其中L_1有162例,L_2有468例,L_3有514例,L_4有93例,L_5有1例,差异有统计学意义(P<0.01)。左旋腰椎683个,右旋腰椎555个,差异有统计学意义(P<0.05)。左旋腰椎中,L1有84例,L_2有266例,L_3有289例,L_4有44例,L_5有0例,差异有统计学意义(P<0.01);右旋腰椎中,L_1有78例,L_2有202例,L_3有225例,L_4有49例,L_5有0例,差异有统计学意义(P<0.01)。683例左旋腰椎棘突与中心轴线位置关系的比较中,位于中轴线左侧605例,位于中轴线右侧1例,位于中轴线上77例,差异有统计学意义(P<0.01);555例右旋腰椎棘突与中心轴线位置关系的比较中,位于中轴线左侧0例,位于中轴线右侧468例,位于中轴线上87例,差异有统计学意义(P<0.01)。500例腰椎正位X线片上,35例只有1个旋转腰椎,208例同时有2个旋转腰椎,242例同时有3个旋转腰椎,14例同时有4个旋转腰椎,1例同时有5个旋转腰椎,差异有统计学意义(P<0.01)。结论:临床不能以棘突位于中心轴线而肯定椎体无旋转,也不能以棘突偏离中心轴线而肯定椎体有旋转;不能以把棘突"拨正"作为脊柱推拿手法治疗是否"到位"的标准。腰椎多椎体同时旋转的情况不多,腰椎下段相较于上段旋转更少、更稳定。Objective：To clarify the relationship between the spinous process and the central axis of the rotating lumbar spine, so as to explore the significance of ＂spinous process deviation＂ in the diagnosis and treatment of ＂ joint semidisloca- tion＂. Methods： 500 cases diagnosed as posterior articular disorder of lumbar vertebra in our department from June 2017 to June 2018 were selected. According to Nash-Moe method, lumbar spinous process and central axis of lumbar spine were observed and evaluated with anteroposterior X-ray film. Results：The X-ray films of 500 cases showed a total of 1238 rota- ted lumbar vertebrae, of which 162 were L1 , 468 were L2 , 514 were L3 , 93 were L4, and 1 was L5. The difference was statistically significant （P^0.01）. There were 683 left-handed lumbar vertebrae and 555 right-handed lumbar vertebrae, and the difference was statistically significant （P〈0.05）. For the left-handed lumbar vertebrae, there are 84 of L1 , 266 of L2, 289 of L3 and 44 of L4. The difference was statistically significant （P〈0.01）. For the right handed lumbar verte- brae, there are 78 of L1 , 202 of L2 , 225 of L3 and 49 of L4 , and the difference was statistically significant （P〈0.01）. A- mong 683 left-handed lumbar vertebrae, 605 were located on the left side of the central axis, 1 was located on the right side of the central axis, 77 were located on the central axis, and the difference was statistically significant （P〈0.01）. A-mong 555 right-handed lumbar vertebrae, 468 were located on the right side of the central axis and 87 were located on the central axis, and the difference was statistically signifi-cant （P〈0.01）. In 500 cases of lumbar vertebrae, 35 cases had only one rotating lumbar vertebrae, 208 cases had two rotating lumbar vertebrae, 242 cases had three rotating lumbar vertebrae, 14 cases had four rotating lumbar vertebrae and 1 case had five rotating lumbar vertebrae. The difference was statistically significant （P〈0.01）. Conclusion;It is not cer- ta

关 键 词：旋转椎体 腰椎棘突 中心轴线 脊柱椎拿 骨错缝 

分 类 号：R681.5[医药卫生—骨科学]