Abbas J, Hamoud K, May H, Hay O, Medlej B, Masharawi Y, Peled N, Hershkovitz I
Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel-Aviv University, Ramat Aviv, 69978 Tel Aviv, Israel.
Eur Spine J. 2010 Nov;19(11):1865-73. doi: 10.1007/s00586-010-1516-5. Epub 2010 Jul 21.
As life expectancy increases, degenerative lumbar spinal stenosis (DLSS) becomes a common health problem among the elderly. DLSS is usually caused by degenerative changes in bony and/or soft tissue elements. The poor correlation between radiological manifestations and the clinical picture emphasizes the fact that more studies are required to determine the natural course of this syndrome. Our aim was to reveal the association between lower lumbar spine configuration and DLSS. Two groups were studied: the first included 67 individuals with DLSS (mean age 66 ± 10) and the second 100 individuals (mean age 63.4 ± 13) without DLSS-related symptoms. Both groups underwent CT images (Philips Brilliance 64) and the following measurements were performed: a cross-section area of the dural sac, vertebral body dimensions (height, length and width), AP diameter of the bony spinal canal, lumbar lordosis and sacral slope angles. All measurements were taken at L3 to S1. Vertebral body lengths were significantly greater in the DLSS group at all levels compared to the control, whereas anterior vertebral body heights (L3, L4, L5) and middle vertebral heights (L3, L5) were significantly smaller in the LSS group. Lumbar lordosis, sacral slope and bony spinal canal were significantly smaller in the DLSS compared to the control. We conclude that the size and shape of vertebral bodies and canals significantly differed between the study groups. A tentative model is suggested to explain the association between these characteristics and the development of degenerative spinal stenosis.
随着预期寿命的增加,退行性腰椎管狭窄症(DLSS)成为老年人中常见的健康问题。DLSS通常由骨骼和/或软组织成分的退行性改变引起。影像学表现与临床表现之间的相关性较差,这突出了需要更多研究来确定该综合征自然病程的事实。我们的目的是揭示下腰椎形态与DLSS之间的关联。研究了两组:第一组包括67例DLSS患者(平均年龄66±10岁),第二组包括100例无DLSS相关症状的个体(平均年龄63.4±13岁)。两组均接受了CT扫描(飞利浦Brilliance 64排),并进行了以下测量:硬脊膜囊横截面积、椎体尺寸(高度、长度和宽度)、骨性椎管前后径、腰椎前凸和骶骨倾斜角。所有测量均在L3至S1水平进行。与对照组相比,DLSS组各节段椎体长度均显著更长,而LSS组椎体前高度(L3、L4、L5)和椎体中部高度(L3、L5)显著更小。与对照组相比,DLSS组的腰椎前凸、骶骨倾斜度和骨性椎管显著更小。我们得出结论,研究组之间椎体和椎管的大小及形状存在显著差异。提出了一个初步模型来解释这些特征与退行性椎管狭窄症发展之间的关联。
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