Rahmani Maryam, Vaziri Bozorg Seyed Mehran, Ghasemi Esfe Ahmad Reza, Morteza Afsaneh, Khalilzadeh Omid, Pedarzadeh Elham, Shakiba Madjid
Advanced Diagnostic & Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Hospital, Tehran University of Medical Sciencse, Tehran 14176-13151, Iran.
Int J Biomed Imaging. 2011;2011:868632. doi: 10.1155/2011/868632. Epub 2011 Jun 28.
Aim. To determine the level of the conus medullaris-Tuffier's line, and conus medullaris-Tuffier's line distance using imaging and evaluate their relation to age and gender. Methods. We performed a cross-sectional study of 189 adult participants, who underwent MR imaging of lumbosacral spine. Each vertebra was divided into 3 equal segments (upper, middle, and lower), and intervertebral disc space was also assumed as one segment. All segments from T12 upper segment to L5S1 intervertebral disc were numbered consecutively. The position of conus medullaris and Tuffier's line was determined by the vertebral segment or intervertebral disc space at the same level. The patients were stratified into high/low conus medullaris position (cutpoint: L1 middle segment) and short/long conus-Tuffier's distance (cutpoint: 14 segments). Results. Women with low conus were significantly more than men, in patients older than 50 years old (72.7% in females versus 55.3% in males; P < .05), whereas there was not such a sexual dimorphism in patients younger than 50 years old. Similarly, short conus-Tuffier's distance was more frequent among women than men in patients older than 50 years old (59.7% in females versus 39.5% in males; P < .05), whereas there was not any gender difference in patients younger than 50 years old. Conus-Tuffier's distance was negatively correlated with age (r = -0.32, P < .001) in all studied population. Conclusion. Anatomical landmarks vary according to age and gender, with a lower end of conus medullaris in women, so clinicians should use more caution on the identification of the appropriate site for lumbar puncture, particularly in elderly women.
目的。利用影像学确定脊髓圆锥-图菲埃线的水平以及脊髓圆锥-图菲埃线的距离，并评估它们与年龄和性别的关系。方法。我们对189名成年参与者进行了横断面研究，这些参与者接受了腰骶部脊柱的磁共振成像检查。每个椎体被分为3个相等的节段（上、中、下），椎间盘间隙也被视为一个节段。从T12上节段到L5S1椎间盘的所有节段连续编号。脊髓圆锥和图菲埃线的位置由同一水平的椎体节段或椎间盘间隙确定。患者被分层为脊髓圆锥高位/低位（切点：L1中节段）和脊髓圆锥-图菲埃线距离短/长（切点：14个节段）。结果。在50岁以上的患者中，脊髓圆锥低位的女性明显多于男性（女性为72.7%，男性为55.3%；P < 0.05），而在50岁以下的患者中没有这种性别差异。同样，在50岁以上的患者中，脊髓圆锥-图菲埃线距离短的情况在女性中比男性更常见（女性为59.7%，男性为39.5%；P < 0.05），而在50岁以下的患者中没有任何性别差异。在所有研究人群中，脊髓圆锥-图菲埃线距离与年龄呈负相关（r = -0.32，P < 0.001）。结论。解剖标志因年龄和性别而异，女性的脊髓圆锥下端较低，因此临床医生在确定腰椎穿刺的合适部位时应更加谨慎，尤其是在老年女性中。
