健康成人腰椎椎间隙高度的解剖学分型及临床意义

doi:10.6040/j.issn.1671-7554.0.2019.130

摘要/Abstract

摘要： 目的观察健康成年人腰椎椎间隙高度变化及对于不同高度的解剖学分型。方法选取行脊柱全长片及腰椎磁共振志愿者169例,测量L_1/2、L_2/3、L_3/4、L_4/5、L₅/S₁椎间隙高度(H1~H5)及L₁~L₅椎体高度,分析男女志愿者各椎间隙绝对高度及相对高度(该椎间隙高度/上位椎体高度,H1/L1~H5/L₅),以及各类型椎间隙高度人群数量分布。结果椎间隙高度及相对椎间隙高度均随结构位置的降低逐渐增加,在L_4/5达到最大值,相邻椎间隙高度差异有统计学意义(P<0.05)。而同一组椎间隙高度中,男女间差异无统计学意义(P>0.05),L_4/5椎间隙测量中有11.83%志愿者(20/169例)有高椎间隙的表现。在H1/L₁组中有66.67%男性志愿者属于相对低间隙组(56/84例),在H2/L₂~H5/L₅组中有75.15%(127/169例)、73.96%(125/169例)、71.01%(120/169例)、65.68%(111/169例)相对椎间隙高度比在0.4~0.5之间,而在H3/L₃、H4/L₄、H5/L₅组中有8.28%(17/169例)、23.67%(40/169例)、8.28%(17/169例)属于相对高间隙组。结论 L_4/5椎间隙高度在健康成人腰椎椎间隙高度中最高,健康成人腰椎椎间隙高度差异大,对椎间隙高度的解剖学分型具有一定临床意义。

关键词: 健康成人, 椎间隙高度, 高椎间隙, 解剖学分型

Abstract: Objective To observe the changes of lumbar intervertebral space heights in healthy adults and the anatomical classification of different heights. Methods A total of 169 volunteers who received full-length spine and lumbar magnetic resonance in our hospital were involved. The L_1/2, L_2/3, L_3/4, L_4/5, L₅/S₁ intervertebral space heights(H1-H5)and L₁-L₅ vertebral height were measured to analyze the absolute height and relative height of each intervertebral space in male and female volunteers(the height of the intervertebral space/upper vertebral height, H1/L₁-H5/L₅)and the distribution of various types of intervertebral space. Results Both of the height and relative height of intervertebral space increased gradually with the decrease of the structural position at L_4/5, and the difference between the heights of adjacent intervertebral space was statistically significant (P<0.05). There was no significant difference between male and female in the same intervertebral space (P>0.05). In the L_4/5 intervertebral space measurement, 11.83% volunteers(20/169)had high intervertebral space. In the H1/L₁ intervertebral space measurement, 66.67% male volunteers had relatively low space(56/84). In the H2/L₂-H5/L₅ intervertebral space measurement, 75.15%(127/169), 73.96% 山东大学学报 (医学版)57卷5期 -陈辰,等.健康成人腰椎椎间隙高度的解剖学分型及临床意义 \=-(125/169), 71.01%(120/169), 65.68%(111/169)volunteers had relative intervertebral space height ratio of 0.4-0.5. In the H3/L₃, H4/L₄, and H5/L₅ intervertebral space measurement, 8.28%(17/169), 23.67%(40/169), 8.28%(17/169)volunteers had relatively high space. Conclusion The L_4/5 intervertebral space height is the highest in the lumbar intervertebral space of healthy adults. There is significant difference in the height of lumbar intervertebral space among healthy adults. The anatomical classification of intervertebral space height has clinical significance.

Key words: Healthy adult, Intervertebral space height, High intervertebral space, Anatomical classification

中图分类号:

R681.5

陈辰,张凯,张锋,赵杰. 健康成人腰椎椎间隙高度的解剖学分型及临床意义[J]. 山东大学学报 (医学版), 2019, 57(5): 43-47.

CHEN Chen, ZHANG Kai, ZHANG Feng, ZHAO Jie. Anatomical classification and clinical significance of lumbar intervertebral space height in healthy adults[J]. Journal of Shandong University (Health Sciences), 2019, 57(5): 43-47.

参考文献

[1] Yang G, Wang Y, Zeng Y, et al. Rapid health transition in China, 1990-2010: findings from the Global Burden of Disease Study 2010 [J]. Lancet(London, England), 2013, 381(9882): 1987-2015.
[2] Paholpak P, Wang Z, Sakakibara T, et al. An increase in height of spinous process is associated with decreased heights of intervertebral disc and vertebral body in the degenerative process of lumbar spine [J]. Eur Spine J, 2013, 22(9): 2030-2034.
[3] 吴建锋, 贾连顺, 李家顺, 等. 腰椎MRI间盘信号及高度的改变与椎间盘源性腰痛的相关性研究[J]. 中国医疗前沿, 2009, 4(1): 1-3. WU Jianfeng, JIA Lianshun, LI Jiashun, et al. The correlation study of the signal and height of the MRI for the lumbar disc and the discogenic low back pain [J]. China Healthcare Frontiers, 2009, 4(1): 1-3.
[4] 王晓东, 马丽, 王德洪, 等. 60-69岁老年人腰椎椎间隙高度与慢性腰痛的相关性研究[J]. 中国运动医学杂志, 2013, 32(6): 540-544.
[5] Cinotti G, De Santis P, Nofroni I, et al. Stenosis of lumbar intervertebral foramen: anatomic study on predisposing factors [J]. Spine, 2002, 27(3): 223-229.
[6] Morishita Y, Masuda M, Maeda T, et al. Morphologic Evaluation of Lumbosacral Nerve Roots in the Vertebral Foramen: Measurement of Local Pressure of the Intervertebral Foramen [J]. Clinical Spine Surgery, 2017, 30(6): 839-844.
[7] Yan S, Zhang Y, Wang K, et al. Three-dimensional morphological characteristics of lower lumbar intervertebral foramen with age [J]. Biomed Res Int, 2018, 2018, 8157061. doi: 10.1155/2018/8157061.
[8] Teichtahl AJ, Urquhart DM, Wang Y, et al. Modic changes in the lumbar spine and their association with body composition, fat distribution and intervertebral disc height -a 3.0 T-MRI study [J]. BMC musculoskeletal disorders, 2016, 17: 92. doi: 10.1186/s12891-016-0934-x.
[9] Barrey C, Roussouly P, Le Huec JC, et al. Compensatory mechanisms contributing to keep the sagittal balance of the spine [J]. European spine journal, 2013, 22(Suppl 6): 834-841.
[10] 赵亮, 瞿东滨, 金大地. 正常人腰椎间盘的MRI测量及其临床意义[J]. 中国脊柱脊髓杂志, 2003, 13(4): 241-243. ZHAO Liang, QU Dongbin, JIN Dadi. MRI measurement of lumbar disc in normal adult and its clinical significance [J]. Chinese Journal of Spine and Spinal Cord, 2003, 13(4): 241-243.
[11] Roussouly P, Gollogly S, Berthonnaud E, et al. Classification of the normal variation in the sagittal alignment of the human lumbar spine and pelvis in the standing position [J]. Spine, 2005, 30(3): 346-353.
[12] Zhang F, Zhang K, Tian HJ, et al. Correlation between lumbar intervertebral disc height and lumbar spine sagittal alignment among asymptomatic Asian young adults [J]. J Orthop Surg Res, 2018, 13(1): 34.
[13] 龚克. 正常人群腰椎椎间高度指数、椎间角度、腰椎前凸角的研究分析及椎间高度指数与椎间盘 Pfirrmann分级的相关性研究[D]. 西安: 空军军医大学, 2018.
[14] Bach K, Ford J, Foley R, et al. Morphometric Analysis of Lumbar Intervertebral Disc Height: An Imaging Study [J]. World Neurosurg, 2018, 20: 1878-8750. doi: 10.1016/j.wneu.
[15] Allaire BT, DePaolis Kaluza MC, Bruno AG, et al. Evaluation of a new approach to compute intervertebral disc height measurements from lateral radiographic views of the spine [J]. European spine journal, 2017, 26(1): 167-172.
[16] Menezes-Reis R, Bonugli GP, Dalto VF, et al. Association between lumbar spine sagittal alignment and L4-L5 disc degeneration among asymptomatic young adults [J]. Spine, 2016, 41(18): 1081-1087.
[17] 刘耀升, 陈其昕, 廖胜辉, 等. 椎间盘高度降低及退变对腰椎生物力学影响的有限元分析[J]. 中国临床解剖学杂志, 2006, 24(5): 566-570. LIU Yaosheng, CHEN Qixin, LIAO Shenghui, et al. The effect of disc height and degeneration on th mechanical behavior of lumbar spine: a finite element analysis [J]. Chinese Journal Of Clinical Anatomy, 2006, 24(5): 566-570.
[18] Teichtahl AJ, Urquhart DM, Wang Y, et al. A Dose-response relationship between severity of disc degeneration and intervertebral disc height in the lumbosacral spine [J]. Arthritis Res Ther, 2015, 17: 297.doi: 10.1186/s13075-015-0820-1.
[19] Sebaaly A, Grobost P, Mallam L, et al. Description of the sagittal alignment of the degenerative human spine [J]. Eur Spine J, 2018, 27(2): 489-496.
[20] Vodicar M, Košak R, Gorenšek M, et al. Vertebral end-plate perforation for intervertebral disc height preservation after single-level lumbar discectomy: a randomized-controlled trial [J]. Clin Spine Surg, 2017, 30(6): 707-712.
[21] 杨璐, 邢浩然, 陈晶晶, 等. 腰椎间盘退变时椎间盘高度变化及其临床意义[J]. 中国临床解剖学杂志, 2017, 35(3): 355-358. YANG Lu, XING Haoran, CHEN Jingjing, et al. Change of intervertebral disc height during degeneration and its clinical significance[J]. Chinese Journal of Clinical Anatomy, 2017, 35(3): 355-358.
[22] Laouissat F, Sebaaly A, Gehrchen M, et al. Classification of normal sagittal spine alignment: refounding the Roussouly classification[J]. Eur Spine J, 2018, 27(8): 2002-2011.
[23] Cheng X, Zhang F, Zhang K, et al. Effect of single-level transforaminal lumbar interbody fusion on segmental and overall lumbar lordosis in patients with lumbar degenerative disease [J]. World Neurosurg, 2018, 109: 244-251. doi: 10.1016/j.wneu.2017.09.154.
[24] Zhong W, Driscoll SJ, Tsai TY, et al. In vivo dynamic changes of dimensions in the lumbar intervertebral foramen [J]. Spine J, 2015, 15(7): 1653-1659.
[25] Zhao X, Du L, Xie Y, et al. Effect of lumbar lordosis on the adjacent segment in transforaminal lumbar interbody fusion: a finite element analysis [J]. World Neurosurg, 2018, 114: 114-120. doi: 10.1016/j.wneu.2018.02.073.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed