L_(4)~S_(1)椎弓根形态与椎板间及椎间孔大小的相关性  

Correlation between pedicle morphology of L_(4)-S_(1) and size of interlaminate and foramen

作　　者：王璨 王亮 李阳 王海滨 高忠亚 卢旭华 陈路[1] Wang Can;Wang Liang;Li Yang;Wang Haibin;Gao Zhongya;Lu Xuhua;Chen Lu(Department of Orthopedics,Affiliated Hospital of North Sichuan Medical College,Nanchong 637100,Sichuan,China;Department of Orthopedics,Changzheng Hospital,Naval Medical University,Shanghai 200003,China)

机构地区：[1]川北医学院附属医院骨科,南充637100 [2]海军军医大学长征医院骨科,上海200003

出　　处：《脊柱外科杂志》2024年第1期21-26,共6页Journal of Spinal Surgery

基　　金：海军军医大学附属第二医院示范性研究型病房开展的研究者发起的临床研究项目(2023YJBF-PY04)。

摘　　要：目的研究腰椎椎弓根形态(长度及角度)与L_(4)/L_(5)和L_(5)/S_(1)节段椎板间及椎间孔大小的相关性。方法回顾性分析海军军医大学长征医院2020年1月—2022年6月收治的50例L_(4)/L_(5)或L_(5)/S_(1)单节段腰椎椎间盘突出症(LDH)患者作为研究组,并选取同时期50名健康志愿者作为对照组。测量2组腰椎正侧位X线片上L_(4)/L_(5)和L_(5)/S_(1)节段椎板间的最大高度和宽度,在CT上测量椎弓根长度和角度、椎间孔最小高度和宽度,采用逐步多元线性回归的多元相关性来确定相关变量对椎间孔及椎板间大小的独立影响。结果2组L_(4)~S_(1)椎弓根长度、L_(4)/L_(5)及L_(5)/S_(1)节段椎间孔和椎板间高度差异无统计学意义(P>0.05)。研究组S_(1)椎弓根外展角小于对照组;研究组L_(4)椎弓根头倾角低于对照组,S_(1)椎弓根头倾角高于对照组;研究组L_(4)与L_(5)、L_(5)与S_(1)椎弓根头倾角差值低于对照组;研究组L_(4)/L_(5)和L_(5)/S_(1)节段椎间孔宽度、椎板间宽度小于对照组;以上指标差异均有统计学意义(P<0.05)。Pearson相关分析显示,年龄与椎板间高度和宽度及椎间孔高度呈负相关,椎弓根外展角与椎板间宽度呈正相关,椎弓根长度与椎间孔宽度呈正相关,相邻腰椎椎弓根头倾角差值与椎间孔宽度呈正相关,椎板间宽度与椎间孔宽度呈正相关。多重线性回归分析显示,患者的年龄、椎弓根长度及角度与椎板间及椎间孔大小独立相关,L_(5)、S_(1)椎弓根外展角与椎板间宽度显著正相关,L_(5)椎弓根头倾角与L_(4)/L_(5)及L_(5)/S_(1)椎间孔高度显著负相关;相邻腰椎椎弓根头倾角差值与椎间孔宽度显著正相关。结论椎板间及椎间孔高度和宽度会随着患者年龄增长而变小,椎板间宽度随着L_(5)、S_(1)椎弓根外展角度增大而变大,L_(5)椎弓根头倾角越大,相邻椎间孔高度越小;相邻椎体椎弓根头倾角差值增加,椎间孔宽度增大。椎弓�Objective To study the correlation between the lumbar pedicle shape(length and angle)and the size of intervertebral foramen in L_(4)/L_(5) and L_(5)/S_(1) segments.Methods From January 2020 to June 2022,50 patients with L_(4)/L_(5) or L_(5)/S_(1) lumbar disc herniation(LDH)in Changzheng Hospital of Naval Medical University were selected as the study group,and 50 healthy volunteers were selected as the control group.The maximum height and width of the L_(4)/L_(5) and L_(5)/S_(1) interlaminar space were measured on anterolateral and lateral lumbar roentgenographs,and the pedicle length and angle and the minimum height and width of the foramen were measured on CT.The multiple correlation of stepwise multiple linear regression was used to determine the independent influence of related variables on the size of intervertebral foramen and intervertebral disc.Results There were no significant difference in pedicle length at L_(4)-S_(1),foramina height and interlaminar height at L_(4)/L_(5) and L_(5)/S_(1) segments between the 2 groups(P>0.05).The abduction angle of S_(1) pedicle in the study group was smaller than that in the control group.The L_(4) pedicle head inclination angle in the study group was higher than that of the control group,and S_(1) pedicle head inclination angle was lower than that of the control group.The differences of pedicle head inclination between L_(4) and L_(5),L_(5) and S_(1) were higher than those in the control group.Width of intervertebral foramen and lamina in L_(4)/L_(5) and L_(5)/S_(1) segments in the study group were smaller than those in the control group.There were significant differences in the above indexes(P<0.05).Pearson correlation analysis showed that age was negatively correlated with the height and width of the intervertebral lamina,as well as the height of the intervertebral foramen;the abduction angle of the pedicle was positively correlated with the width of the intervertebral lamina;length of the pedicle was positively correlated with the width of the intervertebral foramen

关 键 词：腰椎 椎间盘退行性变 摄影测量法 

分 类 号：R681.533[医药卫生—骨科学]