腰椎间盘直径及椎间孔直径与神经根压迫间的解剖关系  

Anatomical relationship between lumbar disc diameter and intervertebral foraminal diameter with nerve root compression

作　　者：谈俊 李炜[2] 代震宇 晏怡[1] 夏永智[1] TAN Jun;LI Wei;DAI Zhenyu;YAN Yi;XIA Yongzhi(Department of Neurosurgery,First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China;Department of Pain,Chongqing Municipal Hospital of Traditional Chinese Medicine,Chongqing 400021,China;Department of Orthopedics,Chongqing Municipal Hospital of Traditional Chinese Medicine,Chongqing 400021,China)

机构地区：[1]重庆医科大学附属第一医院神经外科,400016 [2]重庆市中医院疼痛科,400021 [3]重庆市中医院骨伤科,400021

出　　处：《重庆医学》2021年第10期1737-1740,共4页Chongqing medicine

基　　金：重庆市中青年医学高端后备人才项目(2017HBRC012)。

摘　　要：目的通过磁共振成像(MRI)技术测量成人椎间盘、椎间孔和神经根的相关解剖参数,探讨腰椎间盘垂直直径(DVD)、椎间孔垂直直径(FVD)、椎间孔前后径(FTD)与腰椎神经根受压间的关系。方法系统随机抽样2019-2020年因腰腿痛而接受MRI检查的患者92例,使用矢状面MRI图像测量研究参数:DVD、FVD、FTD、神经根直径(NRD),分析测量参数之间的关系。结果FVD是FTD的两倍左右,各节段DVD完全损失后的FVD均大于NRD。除左侧L2~3和L5~S1、右侧L3~4和L4~5外,其余腰椎节段DVD和FVD之间存在明显相关性,左侧L1~2、L3~4、L4~5和右侧L1~2、L2~3、L5~S1处DVD和FVD的变化具有明显的相关性(左侧:L1~2 r=0.63、P<0.01,L3~4 r=0.60、P<0.05,L4~5 r=0.63、P<0.05;右侧:L1~2 r=0.68、P<0.01,L2~3 r=0.58、P<0.01,L5~S1 r=0.82、P<0.01)。所有腰椎节段,DVD和FTD之间的相关性不明显。结论FVD减小并未造成神经根的压迫,FTD减少更有可能引起椎间孔处神经根的压迫,故改善FTD的狭窄程度,对于减轻出孔神经根的压迫更具有解剖学意义。Objective To study the relationship between vertical diameter of lumbar disc(DVD),vertical diameter of foramina(FVD)and anterior and posterior diameter of foramina(FTD)with compression of lumbar vertebral nerve root by measuring the related anatomical parameters of adult intervertibral disc,intervertebral foramen and nerve root via the magnetic resonance imaging(MRI)technique.Methods A total of 92 patients receiving MRI examination due to waist and leg pain were randomly selected by using the systematic random sampling.The sagittal plane MRI images were used to measure the study parameters:DVD,FVD,FTD,diameter of nerve root(NRD),and the relationship among the measurement parameters was analyzed.Results FVD was about twice that of FTD,and the FVD after the complete loss of all segments of DVD was greater than that of NRD.There were significant correlations between DVD and FVD in all lumbar vertebral segments except L2-3 and L5-S1 on the left side and L3-4 and L4-5 on the right side.The changes of DVD and FVD on the left side L1-2,L3-4,L4-5 and the right side L1-2,L2-3,L5-S1 had significant correlation(left side:L1-2 r=0.63,P<0.01,L3-4 r=0.60,P<0.05,L4-5 r=0.63,P<0.05;right side:L1-2 r=0.68,P<0.01,L2-3 r=0.58,P<0.01,L5-S1 r=0.82,P<0.01).There was no significant correlation between DVD and FTD at all lumbar segments.Conclusion FVD decrease can not cause the nerve root compression,FTD decrease is more likely to cause the compression of the nerve root at the intervertebral foramina.Therefore,improving the stenosis degree of FTD has more anatomical significance for alleviating the compression of the nerve root at the foramina.

关 键 词：腰椎间盘 椎间孔 神经根压迫 解剖关系 

分 类 号：R651.2[医药卫生—外科学]