Department of Orthopaedic, Peking University Third Hospital, Beijing 100191, China.
Chin Med J (Engl). 2010 Jun;123(11):1422-5.
Lumbar spinal stenosis is a common problem that is receiving attention with the advent of novel treatment procedures. Prior positional MRI studies demonstrated lumbar canal diameter changes with flexion and extension. There have not been any studies to examine the amount of spinal canal diameter change relative to the amount of angular motion. The purpose of this study was to evaluate the correlation between the lumbar canal diameter change and the angular motion quantitatively.
Positional MRI (pMRI) images for 491 patients, including 310 males and 181 females (16 years-85 years of age), were obtained with the subjects in sitting flexion 40 degree, upright, and with extension of 10 degrees within a 0.6 T Positional MRI scanner. Quantitative measurements of the canal diameter and segmental angle of each level in the sagittal midline plane were obtained for each position. Then the diameter change and angular motion were examined for correlation during flexion and extension with linear regression analysis.
The lumbar segmental angles were lordotic in all positions except L1-2 in flexion. The changes of canal diameters were statistically correlated with the segmental angular motions during flexion and extension (P < 0.001). The amount of canal diameter change correlated with the amount of angular change and was expressed as a ratio.
Positional MRI demonstrated the amount of spinal canal diameter change that was statistically correlated with the segmental angular motion of the spine during flexion and extension. These results may be used to predict the extent of canal diameter change when interspinous devices or positional changes are used to treat spinal stenosis and the amount of increased canal space may be predicted with the amount of angular or positional change of the spine. This may correlate with symptomatic relief and allow for improved success in the treatment of spinal stenosis.
腰椎管狭窄症是一种常见的疾病，随着新的治疗方法的出现，它越来越受到关注。先前的位置性 MRI 研究表明，腰椎管直径在屈伸时发生变化。目前还没有研究检查椎管直径变化与角度运动之间的关系。本研究的目的是定量评估腰椎管直径变化与角度运动之间的相关性。
对 491 例患者（男性 310 例，女性 181 例，年龄 16 岁至 85 岁）进行了位置性 MRI（pMRI）检查，患者在 0.6T 位置性 MRI 扫描仪中分别处于坐位前屈 40 度、直立位和后伸 10 度。对每个位置的矢状中线平面上的管腔直径和节段角度进行了定量测量。然后通过线性回归分析检查屈伸时的直径变化与角运动的相关性。
除前屈时 L1-2 节段外，所有节段均呈前凸。在屈伸过程中，管腔直径的变化与节段角度的变化具有统计学相关性（P<0.001）。管腔直径变化的程度与角度变化的程度相关，并以比值表示。
位置性 MRI 显示了椎管直径变化的程度与脊柱屈伸时的节段角度运动具有统计学相关性。这些结果可用于预测使用棘突间装置或位置变化治疗椎管狭窄时椎管直径变化的程度，并且可以通过脊柱的角度或位置变化来预测增加的椎管空间的程度。这可能与症状缓解相关，并允许提高治疗椎管狭窄症的成功率。
