腰椎横突形态学研究  

A morphological study of lumbar transverse process

作　　者：李兵[1] 姜保国[1] 傅中国[1] 张殿英[1] 杜湘珂[1] 王天兵[1] 

机构地区：[1]北京大学人民医院创伤骨科,100044

出　　处：《中国骨肿瘤骨病》2003年第2期94-97,共4页Chinse Journal Of Bone Tumor And Bone Disease

摘　　要：目的 研究腰椎横突的形态结构,为后路脊柱手术,尤其是后外侧横突间融合术提供详尽的解剖学资料。方法 CE LightSpeed QX/iCT扫描仪检查20名中国人的L_(1-5)共100个椎骨。数据重建后测量200个腰椎横突参数:横突长度、横突宽度、横突厚度、横突冠状面倾斜角和横突水平面倾斜角。观测腰椎横突内外部形态结构及节段性变化特点。结果 各参数左右间差异无显著意义(P>0.05);除L_5外,相同节段内侧、中间宽度差异无显著意义(P>0.05),但与外侧相比差异有显著意义(P<0.01);而相同节段内侧、中间和外侧的厚度均差异有显著意义(P<0.01)。L_1长度最短,约10mm;L_(2、4、5)长度相似,约15mm;L_3最长,约19mm。L_(1-4)厚度节段性变化不明显,但在L_5水平较L_4增大1倍左右。各节段横突宽度、厚度从内到外逐渐变窄、变薄。L_5宽度和厚度在各节段中均最大。横突水平面角均偏向后侧,从冠状面看各节段横突几乎水平走向。结论 横突是腰椎后方的重要结构,虽有一定的形态学规律,但某些横突参数的个性化特点显著,术前利用重建CT详尽地测量横突参数,可以最大程度的保证横突间融合术的安全性,提高融合率。Objective A morphological study that focused on transverse process (TP) of lumbar vertebrae was conducted, which would provide detail anatomic data for posterior operations in lumbar spine, especially in posterolateral gutter fusion. Methods A total of 100 vertebrae from L-5 of 20 Chinese people were scanned by a GE LightSpeed QX/ i computerized tomographic scanner in the axial plane. After images reconstruction using Volume Analysis 2 - D reformatting software, the parameters of 200 lumbar transverse processes, including width, length, thickness of TP and the angles of inclincation of TP in coronal and horizontal section were measured by the same software. The morphologic structure and segmental difference of TP were also observed. Results There was no significant difference between left and right side of every parameter; Excluding L5 , there was no significant difference between medial and middle width of TP in the same segment (P > 0.05) , but obvious significant difference between medial and lateral one (P < 0.01) ; There was significant difference among the medial, middle and lateral length of TP in the same segment ( P < 0.01) . The length of L[ was the shortest, and was about 10mm.The lengths of L2,4,5 were similar, and were about 15mm. The length of L3 was the longest, and was about 19mm; There was no obvious change from L1-4 in thickness, but the thickness of L5 was double that of L4 . The width and thickness of all segments from medial to lateral gradually changed to narrow and thin. L5 was the greatest in width and thickness among all segments. Axial Inclination projected posteriorly without exception . All coronal inclination almost projected horizontally. Conclusions TP is an important part of posterior lumbar vertebrae. There are some orderlinesses in TP morphologic study, but some parameters express obvious individualy. TP parameters obtained from reformatted GT images preoperatively could ensure utmost safety posterolateral gutter fusion procedures and improve fusion rate.

关 键 词：腰椎横突 形态学 后路脊柱手术 后外侧横突间融合术 解剖学 横突长度 横突宽度 横突厚度 横突冠状面倾斜角 

分 类 号：R687[医药卫生—骨科学]