下腰椎椎板、关节突的影像学测量与临床意义

目的:为腰椎椎板、关节突螺钉瞄准器的设计及临床应用提供影像学基础.方法:测量30例腰痛患者的腰椎X线正位片及下腰椎椎板、关节突CT平扫片,获得椎板、关节突钉道长度、椎板厚度、椎板外斜角及柞板下倾角的相关数据.结果:下腰椎椎板、关节突钉道长度(cm):L3/4男性为(4.63±0.75),女性为(4.40±0.63),L4/5男性为(5.12±0.45),女性为(5.03±0.39),L5/S1男性为(5.47±0.65),女性为(5.35±0.57),钉道长度自L3/4至L5/S1逐渐增大,且测鼍数据男性较女性长,有统计学意义.椎板厚度(mm):L3男性为(5.4±0.8),女性为(5.2±0.73),L4男性为(6.7±1.4),女性为(6.4±1.5),L5男性为(6.4±1.4),女性为(6.2±1.45),椎板厚度L4较L3厚,L5较L4薄,男性较女性厚,有统计学意义.椎板外斜角(°):L3/4男性为(46±5.1),女性为(45±4.8),L4/5男性为(43±3.8),女性为(44±4.1),L5/S1男性为(36±3.5),女性为(35±3.0),椎板外斜角自L3/4至L5/S1逐渐减小,男性与女性之间无统计学意义上的差异.椎板下倾角(°):L3/4男性为(49±3.6),女性为(48±3.0),L4/5男性为(47±3.1),女性为(48±2.2),L5/S1男性为(51±2.5),女性为(50±1.8),椎板下倾角L4/5较L3/4小,L5/S1较L4/5大,男、女性之间无统计学差异.结论:通过测量患者影像学资料可获得个体化的下腰椎椎板、关节突螺钉应用的相关数据.在此基础上,设计和应用腰椎椎板、关节突螺钉瞄准器具有可行性.

Imageology of the laminar and articular process of low lumbar laminar and its clinic significance

Obective: To provide imageologic data for the design of the gunsight of lumbar plate and articular process. Methods: The screw path length of the laminar and articular process,the thickness,lateral-oblique angle and inferior-oblique angle of the laminar were measured with lumbar X-ray and CT on 30 cases suffered from back pain. Results: The screw path length of the laminar and articular process increased gradually from L3/4 to L5S1,which were (4.63±0.75)cm,(4.40±0.63)cm,(5.12±0.45)cm,(5.03±0.39)cm,(5.47±0.65)cm and (5.35±0.57)cm at the levels of L3/4,L4/5,L5S1 for male and female respectively. Laminar thickness of L4 was greater than that of L3 and L5 which were (5.4±0.8)mm,(5.2±0.73)mm,(6.7±1.4)mm,(6.4±1.5)mm,(6.4±1.4)mm and (6.2±1.45)mm at the levels of L3,L4 and L5 for male and female respectively. Laminar lateral-oblique angle decreased gradually from L3/4 to L5S1,which were (45±4.8)°,(43±3.8)°,(44°4.1)°,(36±3.5)°and (35±3.0)°at the levels of L3/4 L4/5,L5/S1 for male and female respectively. Laminar inferior-oblique angle of L3/4 was bigger than that of L4/5 and L5/S1,which were (49±3.6)°,(48±3.0)°,(47±3.1)°,(48±2.2)°,(51±2.5)°and (50±1.8)°at the levels of L3/4 L4/5 and L5/S1 for male and female respectively. Conclusions: Individual data of laminar and articule process of low luimbar could be obtained by imageologic detection,which is a base for designing gunsight of lumbar plate and articular process.