黄韧带厚度在正常和狭窄腰椎中的变化。

Ligamentum flavum thickness in normal and stenotic lumbar spines.

机构信息

Department of Anatomy and Anthropology, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel.

出版信息

Spine (Phila Pa 1976). 2010 May 20;35(12):1225-30. doi: 10.1097/BRS.0b013e3181bfca15.

DOI:10.1097/BRS.0b013e3181bfca15

PMID:20216339

Abstract

STUDY DESIGN

A descriptive computed tomography (CT) study of the ligamentum flavum (LF) thickness in individuals with normal and stenotic lumbar spines.

OBJECTIVE

To establish standards for normal and pathologic range of LF thickness and its asymmetry as indicated in CT images and to examine its association with vertebral body size, age, and gender.

SUMMARY OF BACKGROUND DATA

LF lines a considerable part of the posterior and lateral walls of the spinal canal and is a major role contributor to spinal canal stenosis. Due to methodologic deficiencies (e.g., small sample size, lack of control for vertebral body size, gender, and age), the normal range of LF thickness is still controversial. Furthermore, data on important aspect of LF thickness such as left-right differences are missing.

METHODS

Two groups of individuals were studied. The first group included 65 individuals with lumbar spinal stenosis (LSS) (mean age: 66 +/- 9.7 years) and the second, 150 individuals (mean age: 52 +/- 19 years) without LSS-related symptoms. LF thickness was measured on CT images (Philips Brilliance 64), obtained from axial plane scan at the intervertebral disc level. Measurements were performed at the levels of L3-L4, L4-L5, and L5-S1. Analysis of variance and t test were carried out to evaluate the association between LF thickness and demographic factors.

RESULTS

Absolute and relative LF thickness were significantly greater in the LSS group at the levels of L3-L4 and L4-L5 on both sides, compared to control group (P < 0.05). LF thickness was independent of gender (absolute and relative thickness). Even though LF thickness at all levels significantly increases with age, significant changes after the age of 60 occurred only at L3-L4. Significant asymmetry in LF thickness was found at L3-L4 (2.9 +/- 0.90 mm on the right vs. 2.76 +/- 0.90 mm on the left) and L5-S1 (3.42 +/- 1.1 mm on the right vs. 3.22 +/- 1.22 mm on the left) (P < 0.05).

CONCLUSION

LF thickness is an age-dependent and gender-independent phenomenon. LF is significantly thicker on the right side. The borderline between normal and pathologic LF thickness should not be set at 4 mm.

摘要

研究设计

一项关于正常和狭窄腰椎韧带（LF）厚度的描述性计算机断层扫描（CT）研究。

目的

建立 LF 厚度在 CT 图像中的正常和病理范围以及其不对称性的标准，并研究其与椎体大小、年龄和性别之间的关系。

背景资料概述

LF 沿脊柱管的后外侧壁延伸，是椎管狭窄的主要贡献者。由于方法学上的缺陷（例如，样本量小、缺乏对椎体大小、性别和年龄的控制），LF 厚度的正常范围仍存在争议。此外，关于 LF 厚度的一些重要方面的数据，如左右差异，尚不清楚。

方法

研究了两组人群。第一组包括 65 名腰椎管狭窄症（LSS）患者（平均年龄：66 +/- 9.7 岁），第二组包括 150 名无 LSS 相关症状的个体（平均年龄：52 +/- 19 岁）。在椎间盘水平的轴向扫描图像上测量 LF 厚度。在 L3-L4、L4-L5 和 L5-S1 水平进行测量。采用方差分析和 t 检验来评估 LF 厚度与人口统计学因素之间的关系。

结果

与对照组相比，LSS 组在 L3-L4 和 L4-L5 双侧的 LF 绝对和相对厚度均显著增大（P < 0.05）。LF 厚度与性别无关（绝对和相对厚度）。尽管 LF 厚度在所有水平上都随年龄显著增加，但 60 岁以后仅在 L3-L4 水平发生显著变化。在 L3-L4（右侧 2.9 +/- 0.90mm 与左侧 2.76 +/- 0.90mm）和 L5-S1（右侧 3.42 +/- 1.1mm 与左侧 3.22 +/- 1.22mm）水平发现 LF 厚度存在显著不对称性（P < 0.05）。