站位活动腰椎小关节三维CT测量  

Three-dimensional CT measurement of lumbar facet joints in standing activities

作　　者：陈焕雄 文王强 李国军 徐浩翔 张泽佩 苗军 CHEN Huan-xiong;WEN Wang-qiang;LI Guo-jun;XU Hao-xiang;ZHANG Ze-pei;MIAO Jun(Department of Spine and Osteopathic Surgery,The First Affiliated Hospital,Hainan Medical University,Haikou 570102,Hainan,China)

机构地区：[1]海南医学院第一附属医院脊柱外科,海南海口570102

出　　处：《中国矫形外科杂志》2023年第9期828-832,共5页Orthopedic Journal of China

基　　金：国家自然科学基金项目(编号:82160435)。

摘　　要：[目的]分析站立活动时腰椎小关节(lumbar facet joint,LFJ)在体三维运动学特征。[方法]招募10名无腰椎疾病的志愿者。通过高分辨CT获取志愿者腰椎模型并与双荧光透视成像系统获取的图像相匹配,可再现LFJ瞬时运动状态,并分析其位移和旋转角度等运动学特征。[结果]屈伸运动中,在L_(4)~L_(5)节段的旋转范围最大(3.6±2.7)°(P>0.05)。平移范围在L_(5)S_(1)节段最大(P>0.05)。左右平移范围在前后方向上(Y轴方向)L_(3)~L_(4)右侧显著大于左侧[(0.9±0.5)mm vs(0.4±0.5)mm,P<0.05],L_(4)~L_(5)节段左侧显著大于右侧[(1.6±0.8)mm vs(1.1±0.4)mm,P<0.05]。侧弯运动中,在L_(3)~L_(4)节段的旋转范围最大(4.9±4.4)°(P<0.05)。平移范围在L_(3~4)节段最大(P>0.05)。L_(4)~L_(5)水平的左右LFJ平移范围在左右方向(X轴方向)左侧显著大于右侧[(0.7±0.5)mm vs(0.6±0.4)mm,P<0.05]。旋转运动中,L3~L4节段的旋转范围最大(2.6±1.7)°,L_(3)~L_(4)水平的左右LFJ平移范围在左右方向上(X轴方向)右侧显著大于左侧[(0.7±0.5)mm vs(0.6±0.4)mm,P<0.05]。[结论]LFJ在体运动特征与其运动方式有关,复杂姿势以耦合运动为主。[Objective]To analyze the three-dimensional kinematic characteristics of the lumbar facet joint(LFJ)activity when standing.[Methods]Ten volunteers without lumbar disease were recruited,and underwent high-resolution CT and dural fluoroscopy examinations.The lumbar spine model of the volunteers was established matched with the images obtained by the dural fluoroscopic imaging system to reproduce the instantaneous motion state of LFJ,and analyze its kinematic characteristics,such as displacement and rotation angle.[Results]In term of flexion and extension,the maximum rotation range was(3.6±2.7)°at L_(4)~L_(5) segments(P<0.05),while the maximum translation range was at LS segments(P<0.05).The left-right translation range at L_(3)~L_(4) was significantly greater on the right side than on the left side[(0.9±0.5)mm vs(0.4±0.5)mm,P<0.05],while which at L_(4)~L_(5) segment proved greater on the left than the right[(1.6±0.8)mm us(1.1±0.4)mm,P<0.05].In term of lateral bending motion,the maximum rotation range was(4.9±4.4)°in L_(3)~L_(4) segments(P<0.05),while the maximum translation range was at L_(3-4) segments(P<0.05)].The translational range of LFJ at the L_(4)~L_(5),level was significantly greater on the left than on the right[(0.7±0.5)mm vs(0.6±0.4)mm,P<0.05].In term of rotation motion,the rotation range of L_(3)~L_(4) was the largest(2.6±1.7)°,and the translation range of L_(3)~L_(4 )was significantly larger on the right than the left[(0.7±0.5)mm vs(0.6±0.4)mm,P<0.05].[Conclusion]The movement characteristics of LFJ are related to its movement mode,with complex postures dominated by coupled motion.

关 键 词：腰椎小关节 在体运动 运动范围 不对称性 

分 类 号：R681.57[医药卫生—骨科学]