Saengnipanthkul Sukit, Jiraratanaphochai Kitti, Pornpanawal Somkiat, Narakol Pakorn
Department of Orthopaedics, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
J Med Assoc Thai. 2003 Mar;86(3):270-5.
Thoracolumbar AP plain film of 89 subjects (39 males, 50 females) with an average age of 47.6 years (range 21-78 years) from the roentgenographic files were included. Both the IPD and MPD of T11, T12, L1 and L2 were measured by two observers. The mean difference of IPD and MPD at these four levels were compared by using a one-way ANOVA. The relationship of the IPD and MPD measured from the T11 to L2 levels were evaluated using the simple linear regression model.
The mean IPD was progressively wider (p = 0.000) from the T11 to L1 level, but no significant difference (p = 0.308) was found between the mean IPDs of L1 and L2. The mean MPD of each level was significantly different from the others (p = 0.000) except the mean MPDs of T12 and L1 (p = 1.000). Both the IPD and MPD had a statistically significant linear relationship with the level of the vertebrae from T11 to L2 (p = 0.000) with the coefficients of determination (R2) of 0.39 and 0.28, respectively.
More care should be taken in clinical practice when measuring the IPD of a fractured vertebra relative to those of adjacent lower levels in order to determine whether or not widening has occurred, especially IPD L1 vis-à-vis IPD L2. MPD measurement has no advantage over the IPD measurement but is a useful alternative when a comparison of the pedicular distance of L1 and L2 is needed.
纳入89例受试者(39例男性,50例女性)的胸腰椎AP平片,这些平片来自放射科存档资料,平均年龄47.6岁(范围21 - 78岁)。由两名观察者测量第11、12胸椎及第1、2腰椎的IPD和MPD。使用单因素方差分析比较这四个节段IPD和MPD的平均差异。采用简单线性回归模型评估从第11胸椎至第2腰椎节段测量的IPD和MPD之间的关系。
从第11胸椎至第1腰椎节段,平均IPD逐渐变宽(p = 0.000),但第1腰椎和第2腰椎的平均IPD之间无显著差异(p = 0.308)。除第12胸椎和第1腰椎的平均MPD外(p = 1.000),各节段的平均MPD均存在显著差异(p = 0.000)。从第11胸椎至第2腰椎,IPD和MPD与椎体节段均存在显著的线性关系(p = 0.000),决定系数(R2)分别为0.39和0.28。
在临床实践中,测量骨折椎体的IPD相对于相邻较低节段的IPD时应更加谨慎,以确定是否发生增宽,尤其是第1腰椎与第2腰椎的IPD比较时。MPD测量相对于IPD测量并无优势,但在需要比较第1腰椎和第2腰椎的椎弓根间距时是一种有用的替代方法。