CT三维成像评价中国成年人的椎间盘形态  

Morphology of intervertebral disc in Chinese adults evaluated using computer tomography three-dimensional imaging

作　　者：肖侃侃 李兵 彭小忠 卓祥龙 谢超贤 Xiao Kan-kan;Li Bing;Peng Xiao-zhong;Zhuo Xiang-long;Xie Chao-xian(Department of Spine Surgery,Liuzhou Worker’s Hospital,Liuzhou 545007,Guangxi Zhuang Autonomous Region,China;Department of Radiology,Liuzhou Worker’s Hospital,Liuzhou 545007,Guangxi Zhuang Autonomous Region,China)

机构地区：[1]柳州市工人医院脊柱外科,广西壮族自治区柳州市545007 [2]柳州市工人医院放射科,广西壮族自治区柳州市545007

出　　处：《中国组织工程研究》2018年第11期1749-1755,共7页Chinese Journal of Tissue Engineering Research

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费科研课题(Z2016170)~~

摘　　要：背景:人工椎间盘需要高度、宽度、形状尽可能和原有椎间盘相似,才能更好的分布载荷。目前大部分数据来自国外或应用X射线、MRI等仪器测量得出,但都存在一定不足。目的:对正常腰椎椎间盘进行CT测量,以期为脊柱疾病诊断及设计适合国人的腰椎人工椎间盘装置提供数据。方法:收集2012年1月至2017年5月于柳州市工人医院行腰椎CT检查患者共2 235例,经严格纳入排除标准后符合条件者共62例,其中男45例,女17例。从20岁起,10年为界限,分为20-30,31-40,41-50及>50岁组,共4组,节段范围L_1-S_1。测量指标包括椎间盘前后径距离、横径距离,椎间盘体积大小,椎间隙矢状位前中后高度,冠状位左右高度及椎间隙角度。结果与结论:(1)在年龄方面,在L_(1/2)、L_(2/3)、L_(3/4)这些节段上大部分指标差异有显著性意义(P<0.05),需考虑年龄差异;而L4/5、L5/S1节段上大部分指标差异无显著性意义(P>0.05);(2)各节段矢状位上前高与中高、后高高度比较,差异均有显著性意义(P<0.05);(3)L_(2/3)、L_(3/4)、L_(4/5)、L_5/S_1椎间隙角度之间差异均有显著性意义(P<0.05),但是L_(4/5)与L_5/S_1之间角度变化最大;(4)冠状位上左右两侧高度比较,两者间差异无显著性意义(P>0.05);(5)相邻横断面上前后径及横径比较,两者间差异有显著性意义(P<0.05);(6)结果显示,节段越往下,各节段测量指标统计学差异越小。表明腰椎人工椎间盘或椎间融合器设计上,在L_(1/2)、L_(2/3)、L_(3/4)这些节段上需考虑年龄差异;腰椎人工椎间盘可从中间或侧方放置;人工椎间盘需设计成锲形而不是矩形。这些将为设计国产腰椎人工椎间盘提供良好的解剖学依据。BACKGROUND:The artificial disc requires a height,a width,and a shape as much as possible to be similar to the original intervertebral disc in order to perfectly distribute the load.At present,most of the data are from foreign countries or measured using X-ray and magnetic resonance imaging,but there are some shortcomings.OBJECTIVE:To diagnose the spinal disease and provide data for the design of a native lumbar disc device by measuring the normal lumbar intervertebral disc using computer tomography(CT).METHODS:A total of 2 235 patients who underwent lumbar CT examination in Liuzhou Worker’s Hospital from January 2012 to May 2017 were collected and analyzed.There were 62 cases,including 45 males and 17 females,after being strictly met the inclusion and exclusion criteria.From the age of 20,they were divided into four groups:20-30,31-40,41-50 and more than 50 years old.The range was from L1 to S1.The measurement index include intervertebral disc anteroposterior diameter,transerverse diameter,disc volume,sagittal anterior,middle and posterior height,coronal left and right height,and interverterbral angle.RESULTS AND CONCLUSION:(1)In terms of age,there was a statistically significant difference in measurement indexes between L1/2,L2/3 and L3/4(P<0.05).Therefore,the factor of age should be taken into account.However,there was no statistically significant difference between L4/5 and L5/S1 segments(P>0.05).(2)There was a statistical difference between the anterior and middle height of the sagittal position in L4/5 and L5/S1(P<0.05).(3)There were statistical differences between the angles of L2/3,L3/4,L4/5,L5/S1 intervertebral space(P<0.05),but the difference of angle between L4/5 and L5/S1 was the most.(4)There was no statistical difference in the height between the left and right sides of the coronal position(P>0.05).(5)There was statistical difference between the anteroposterior and transverse diameters of the disc on the adjacent cross section(P<0.05).(6)The results showed that the lower the segment,the smaller the

关 键 词：正常 腰椎间盘 腰椎前路融合内固定术 CT测量 腰椎 椎间盘 脊柱融合术 内固定器 组织工程 

分 类 号：R318[医药卫生—生物医学工程]