CT测量189例成人下位腰椎神经根管径值及临床价值探讨  

CT measurement of the nerve root canal diameter of the lower lumbar spine in 189 adults and its clinical value

作　　者：景建[1] 王学斌[1] 许继刚 郭卫建 高惠玲 张晓玲[1] Jing Jian;Wang Xuebin;Xu Jigang;Guo Weijian;Gao Huiling;Zhang Xiaoling(Department of Radiology,Affiliated Hospital of Changzhi Health School,Shanxi 046000,China)

机构地区：[1]长治卫生学校附属医院CT室,046000 [2]山西省长治市中医院CT室 [3]山西省长治市中医研究所CT室

出　　处：《山西医药杂志》2019年第19期2353-2355,共3页Shanxi Medical Journal

摘　　要：目的认识健康成人下位腰椎神经根管的解剖结构;CT测量并找出本地区成人下位腰椎神经根管各段狭窄值以及正常值的医学参考值范围;分析探讨成人下位腰椎神经根管CT狭窄值的临床意义。方法研究成人下位腰椎神经根管的解剖结构,CT测量100名健康成人下位腰神经根管的径值;测量89例患有腰腿痛患者的下位腰神经根管的径值。结果腰神经根管分为盘黄间隙和骨性侧隐窝两部分。100名健康成人下位腰椎盘黄间隙径值中,95%的个体男性为1.56~4.38 mm;女性为2.10~4.33 mm;骨性侧隐窝径值,男性为4.52~8.10 mm,女性为3.82~7.50 mm。选择两者的最小值假设为狭窄值,分别为1.56 mm、3.82 mm。100名健康成人中,有5名18个盘黄间隙和11个骨性侧隐窝小于假设狭窄值;89例患有腰腿痛者中,有21例126个盘黄间隙和个骨性侧隐窝大于狭窄值。结论成人椎骨形态、大小具有地域性差别,其测量方法、医学参考值范围各有不同。对于盘黄间隙和骨性侧隐窝CT诊断为狭窄,但临床诊断不一定成立,需要根据本地区的狭窄医学参考值范围,及其神经根压迫的临床症状进行影像学分析,才能提供更可靠的诊断依据。Objective To understand the anatomical structure of the lower lumbar nerve root canal in healthy adults;to measure and find out the medical reference range of the lower lumbar nerve root canal in adults in the local area;to analyze the clinical significance of CT stenosis value of the lower lumbar nerve root canal in adults.Methods The anatomy of the lower lumbar nerve root canal was studied in adults.The diameter of the lumbar nerve root canal was measured by CT in 100 healthy adults.The diameter of the lower lumbar nerve root canal was measured in 89 patients with low back pain.Results The lumbar nerve root canal was divided into two parts:the disc yellow space and the skeletal side crypt.In 100 healthy adults,the diameter of lower lumbar disc yellow space was 1.56-4.38 mm for 95%of individual males and 2.10-4.33 mm for females.The lateral bony recess diameter value was 4.52-8.10 mm for males and 3.82-7.50 mm for females.The minimum values of the two were assumed to be stenosis values,respectively 1.56 mm and 3.82 mm.Among the 89 patients with lumbar and leg pain,266 patients had disc yellow space stenosis and 72 patients had bony lateral recess stenosis.Conclusion The morphology and size of adult vertebrae have regional differences,and the measurement methods and medical reference values range are also different.For the diagnosis of stenosis in CT,the clinical diagnosis is not necessarily established,and it is more scientific to combine the regional medical reference value range and the imaging analysis of the nerve root compression symptoms.

关 键 词：体层摄影术 螺旋计算机 盘黄间隙 骨性侧隐窝 参考值 

分 类 号：R68[医药卫生—骨科学]