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胸腰椎小关节方向:三维解剖学和生物力学分析

Facet orientation in the thoracolumbar spine: three-dimensional anatomic and biomechanical analysis.

作者信息

Masharawi Youssef, Rothschild Bruce, Dar Gali, Peleg Smadar, Robinson Dror, Been Ella, Hershkovitz Israel

机构信息

Tel-Aviv University, Sackler Faculty of Medicine, School of Health Professions, Department of Physical Therapy, Tel-Aviv, Israel.

出版信息

Spine (Phila Pa 1976). 2004 Aug 15;29(16):1755-63. doi: 10.1097/01.brs.0000134575.04084.ef.

Abstract

STUDY DESIGN

Thoracolumbar facet orientations were measured and analyzed.

OBJECTIVES

To establish a comprehensive database for facet orientation in the thoracolumbar vertebrae and to determine the normal human condition.

SUMMARY OF BACKGROUND DATA

Most studies on facet orientation have based their conclusions on two-dimensional measurements, in small samples or isolated vertebrae. The amount of normal asymmetry in facet orientation is poorly addressed.

METHODS

Transverse and longitudinal facet angles were measured directly from 240 human vertebral columns (males/females, blacks/whites). The specimens' osteologic material is part of the Hamann-Todd Osteological Collection housed at the Cleveland Museum of Natural History (Cleveland, OH). A total of 4,080 vertebrae (T1-L5) from the vertebral columns of individuals 20 to 80 years of age were measured, using a Microscribe three-dimensional apparatus (Immersion Co., San Jose, CA). Data were recorded directly on computer software. Statistical analysis included paired t tests and analysis of variance. RESULTS.: Facet orientation is independent of gender, age, and ethnic group. Asymmetry in facet orientation is found in the thorax. All thoracolumbar facets are positioned in an oblique plane. In the transverse plane, all facets from T1 to T11 are positioned with an anterior inclination of approximately 25 degrees to 30 degrees from the frontal plane. The facets of T12-L2 are oriented closer to the midsagittal plane of the vertebral body (mean range, 25.89 degrees-33.87 degrees), while the facets of L3-L5 are oriented away from that plane (mean range, 40.40 degrees-56.30 degrees). Facet transverse orientation at the thoracolumbar junction is highly variable (approximately 80% with approximately 101 degrees and approximately 20% with 35 degrees). All facets are oriented more vertically from T1 (approximately 150 degrees) to L5 (approximately 170 degrees). The facet sagittal orientations of the lumbar zygoapophyseal joints are not equivalent. CONCLUSIONS.: Asymmetry in facet orientation is a normal characteristic in the thorax.

摘要

研究设计

测量并分析胸腰椎小关节方向。

目的

建立胸腰椎小关节方向的综合数据库并确定正常人体状况。

背景资料总结

大多数关于小关节方向的研究结论基于二维测量、小样本或单个椎体。小关节方向正常不对称的程度研究较少。

方法

直接测量240具人体脊柱标本(男性/女性、黑人/白人)的横向和纵向小关节角度。标本的骨骼材料是克利夫兰自然历史博物馆(俄亥俄州克利夫兰)收藏的哈曼-托德骨骼标本集的一部分。使用三维微scribe仪器(加利福尼亚州圣何塞市Immersion公司)测量了年龄在20至80岁个体脊柱中的4080个椎体(T1-L5)。数据直接记录在计算机软件上。统计分析包括配对t检验和方差分析。结果:小关节方向与性别、年龄和种族无关。胸部存在小关节方向不对称。所有胸腰椎小关节均位于一个斜平面内。在横平面上,从T1到T11的所有小关节相对于额平面向前倾斜约25度至30度。T12-L2的小关节更靠近椎体矢状中线平面(平均范围为25.89度-33.87度),而L3-L5的小关节则远离该平面(平均范围为40.40度-56.30度)。胸腰段交界处小关节的横向方向变化很大(约80%为约101度,约20%为35度)。从T1(约150度)到L5(约170度),所有小关节的方向更垂直。腰椎关节突关节的小关节矢状方向并不相同。结论:小关节方向不对称是胸部的正常特征。

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