The Centre for Musculoskeletal Studies, School of Surgery, The University of Western Australia, Level 2, Medical Research Foundation Building, 50 Murray St, Perth, WA, 6000, Australia.
Eur Spine J. 2010 Jul;19(7):1115-20. doi: 10.1007/s00586-010-1339-4. Epub 2010 Mar 5.
Whilst there are numerous studies examining aspects of sagittal plane motion in the lumbar spine, few consider coronal plane range of motion and there are no in vivo reports of nucleus pulposus (NP) displacement in lateral flexion. This study quantified in vivo NP deformation in response to side flexion in healthy volunteers. Concomitant lateral flexion and axial rotation range were also examined to evaluate the direction and extent of NP deformation. Axial T2- and coronal T1-weighted magnetic resonance images (MRI) were obtained from 21 subjects (mean age, 24.8 years) from L1 to S1 in the neutral and left laterally flexed position. Images were evaluated for intersegmental ranges of lateral flexion and axial rotation. A novel methodology derived linear pixel samples across the width of the disc from T2 images, from which the magnitude and direction of displacement of the NP was determined. This profiling technique represented the relative hydration pattern within the disc. The NP was displaced away from the direction of lateral flexion in 95/105 discs (p < 0.001). The extent of NP displacement was associated strongly with lateral flexion at L2-3 (p < 0.01). The greatest range of lateral flexion occurred at L2-3, L3-4 and L4-5. Small intersegmental ranges of axial rotation occurred at all levels, but were not associated with NP displacement. The direction of NP deformation was highly predictable in laterally flexed healthy lumbar spines; however, the magnitude of displacement was not consistent with the degree of intersegmental lateral flexion or rotation.
虽然有许多研究检查腰椎矢状面运动的各个方面，但很少考虑冠状面活动范围，也没有关于侧屈时髓核（NP）移位的体内报告。本研究定量研究了健康志愿者侧屈时 NP 的体内变形。还同时检查了侧屈和轴向旋转范围，以评估 NP 变形的方向和程度。在中立位和左侧侧屈位，从 L1 到 S1 对 21 名受试者（平均年龄 24.8 岁）进行轴向 T2 和冠状 T1 加权磁共振成像（MRI）。评估节段间侧屈和轴向旋转范围。一种新的方法从 T2 图像上的线性像素样本中获得了跨椎间盘宽度的 NP 位移的大小和方向。这种描边技术代表了椎间盘内的相对水合模式。在 95/105 个椎间盘（p<0.001）中，NP 从侧屈方向移位。NP 位移的程度与 L2-3 的侧屈密切相关（p<0.01）。最大的侧屈范围发生在 L2-3、L3-4 和 L4-5。所有水平的节段间轴向旋转范围都很小，但与 NP 位移无关。在健康的腰椎侧屈中，NP 的变形方向具有高度可预测性；然而，位移的程度与节段间侧屈或旋转的程度不一致。
