下腰椎板间隙的影像解剖学测量及其临床意义

doi:10.13418/j.issn.1001-165x.2021.01.008

Abstract

Abstract: Objective　To measure the anatomical parameters of lumbar laminae interval space with lower lumbar disc herniation (LDH) by an imaging method and to explore the clinical significance in minimally invasive spinal surgery.　Methods　One hundred and forty-five anteroposterior X-ray films with single lumbar disc herniation (L4/5 and L5/S1) were enrolled. The morphological characteristics of the lumbar vertabral laminae interval space between affected side (a symptoms group) and healthy side (a control group) were compared. The height, width and the area of the bilateral vertebral laminae interval space in the segments of L4/5 and L5/S1 were measured by X-rays according to the gender. The available diameter of lumbar laminae interval space was measured by lumbar vertebra 3D CT. Then all data were analyzed statistically. 　Results From the anteroposterior X-ray films of lumbar laminae interval space, the shape of the vertebral laminae interval space in the segments of L4/5 and L5/S1 in the healthy side group was oval, while the shape in the affected side group were in triangle and oblate shapes. The incidence of lumber disc space stenosis in the affected side group was 68.1% in total, including 65.1% happened in L4/5 segment and the incidence of L5/S1 segment was 71%. With the changing in the width of lumbar laminae interval space, the height also changed. The 3D CT result showed that the available diameter of the vertebral laminae interval space in 76.5% of the patients was smaller than the diameter of the working channel. 72.3% of which were located in the L4/5 segment, and 80.6% in the L5/S1 segment. The mean height, width and the area as well as available diameter of the lumbar vertebral laminae interval space in male group were higher than those in female group, and the difference was statistically significant (P<0.05). The average height, width and the area as well as the available diameter in segment L5/S1 were larger than those in segment L4/5.　Conclusions　There was a closed association between lumbar disc herniation and the change of lumbar laminae interval space. With the understanding of the height, width, the area and available diameter of the lumbar vertebral laminae interval space would guide to select the minimally invasive surgical approach and the surgical procedure.

Key words: Lumbar disc herniation, Lumbar laminae interval space, 　Minimally invasive spinal surgery, 　Anatomical parameters

CLC Number:

R813

Zhang Haifeng, Zhan Xinhua, Fu Zeze, Wu Jianfeng, Fu Qiang. Imaging anatomical measurement and clinical significance in minimally invasive surgery of the lower lumbar laminae interval space [J]. Chinese Journal of Clinical Anatomy, 2021, 39(1): 37-40.

References 15

[1]	Schroeder GD, Guyre CA, Vaccaro AR. The epidemiology and pathophysiology of lumbar disc herniations[J]. Semin Spine Surg, 2016, 28(1): 2-7. DOI: 10.1053/j.semss.2015.08.003.
[2]	Dammers R, Koehler PJ. Lumbar disc herniation: level increases with age[J]. Surg Neurol, 2002, 58(3-4): 209-212. DOI: 10.1016/S0090-3019(02)00797-8.
[3]	周兆文. 经椎板间完全内镜下与椎间盘镜下L_5/S_1椎间盘切除术的中期临床疗效比较[J]. 中国现代医学杂志, 2017, 27(27): 77-81. DOI: 10.3969/j.issn.1005-8982.2017.27.014.
[4]	宋富立, 古恩鹏, 王丽萍, 等. 腰椎4/5椎板间隙测量对微创术式选择的价值[J].中国中西医结合外科杂志, 2013, 19(4): 384-385. DOI: 10.3969/j.issn.1007-6948.2013.04.010.
[5]	付强, 陈誉, 徐海栋, 等. 经椎板间隙扩窗入路内窥镜下手术治疗伴椎板间隙狭窄的L5/S1椎间盘突出症[J]. 中国脊柱脊髓杂志, 2013, 23(7): 628-632. DOI: 10.3969/j.issn.1004-406X.2013.07.10.
[6]	Tao SW, Jin L, Hou ZY, et al. A new radiographic feature of lower lumbar disc herniation in young patients[J]. Int Orthop, 2018, 42(3): 583-586. DOI: DOI:10.1007/s00264-017-3723-8.
[7]	赵剑, 贾连顺, 赵敦炎, 等. 腰椎板间撑开减压椎管成形术的解剖学基础[J]. 中国矫形外科杂志, 2003, 11(15): 56-58. DOI: 10.3969/j.issn.1005-8478.2003.15.017.
[8]	朱贵勤, 王柏春, 刘信礼, 等. 腰椎椎板间隙的X线片测量及临床意义[J]. 放射学实践, 2003, 18(7): 504-505. DOI: 10.3969/j.issn.1000-0313.2003.07.016.
[9]	Jang JS, An SH, Lee SH. Transforaminal percutaneous endoscopic discectomy in the treatment of foraminal and extraforaminal lumbar disc herniations[J]. J Spinal Disord Tech, 2006, 19(5): 338-343. DOI: 10.1097/01.bsd.0000204500.14719.2e.
[10]	兰俊, 陈其昕, 翟晓军, 等. 腰椎间盘退变时椎间隙形态与腰椎曲度变化及其临床意义[J]. 中国临床解剖学杂志, 2005, 23(2): 157-159+162. DOI: 10.3969/j.issn.1001-165X.2005.02.012.
[11]	Schulte J. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations[J]. Manuelletherapie, 2017, 21(2): 54-55. DOI: 10.1055/s-0043-105930.
[12]	Luoma K, Vehmas T, Riihimäki H, et al. Disc height and signal intensity of the nucleus pulposus on magnetic resonance imaging as indicators of lumbar disc degeneration[J]. Spine, 2001, 26(6): 680-686. DOI: 10.1097/00007632-200103150-00026.
[13]	李义凯, 朱定军, 李明, 等. 腰椎椎板间隙的放射解剖学测量[J]. 颈腰痛杂志, 1998, 19(2): 57-58. DOI: 10.3969/j.issn.1005-7234.1998.02.029.
[14]	别业俊, 常晓涛, 徐燕笑, 等. 腰椎椎板间隙的放射解剖学测量及分型[J]. 中国临床解剖学杂志, 2018, 36(4): 383-386. DOI: 10.13418/j.issn.1001-165x.2018.04.006.
[15]	娄朝晖, 梁碧玲, 吴卓, 等. 国人腰椎椎体性别差异的分析[J]. 中国组织工程研究与临床康复, 2010, 14(13): 2416-2420. DOI: 10.3969/j.issn.1673-8225.2010.13.034.

Imaging anatomical measurement and clinical significance in minimally invasive surgery of the lower lumbar laminae interval space

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