Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, United States; Department of Orthopaedics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, United States.
J Clin Neurosci. 2019 Aug;66:113-120. doi: 10.1016/j.jocn.2019.05.006. Epub 2019 May 23.
The aim of this study was to evaluate disc degeneration and kinematic changes in translation and angular motion of the thoracic spine using kinematic MRI (kMRI). 105 thoracic spine kMRI were analyzed from T4-5 to T11-12 using MRAnalyzer3. Translational and angular motion were evaluated in neutral, flexion, and extension positions. Thoracic disc height and disc degeneration grading were measured in the neutral position. Intraclass Correlation Coefficients were used to analyze agreement among three observers. The Friedman's test was used to analyze the difference in disc height, disc degeneration, translational motion, and angular motion. The Wilcoxon-signed rank test was used for post-hoc analysis with a Bonferroni correction. A p-value of 0.00625 was used to establish a statistically significant difference. Analysis using the Friedman's test revealed that translational motion, disc height, and disc degeneration were significantly different from T4-5 to T11-12 (p < 0.001). The T4-5 level showed the least translational motion, while the T10-11 showed the most translational motion. The lower thoracic level (T8-12) showed significantly more translational motion, more advanced disc degeneration, and greater disc height than the upper thoracic level (T4-8, p < 0.001). T11-12 showed the most advanced disc degeneration. There was a significant negative correlation between disc degeneration and translational motion at the upper thoracic level (p = 0.013). The lower thoracic region (below T8) had significantly more translational motion, more advanced disc degeneration, and greater disc height. This information is crucial in further understanding thoracic spinal kinematics and may contribute to determining the stopping level in fusion surgeries involving the thoracic spine.
本研究旨在使用运动学 MRI（kMRI）评估胸椎的椎间盘退变和运动学变化，包括平移和角度运动。使用 MRAnalyzer3 分析了 T4-5 至 T11-12 节段的 105 例胸椎 kMRI。在中立、前屈和后伸位评估平移和角度运动。在中立位测量胸椎椎间盘高度和椎间盘退变分级。使用组内相关系数分析三位观察者之间的一致性。采用 Friedman 检验分析椎间盘高度、椎间盘退变、平移运动和角度运动的差异。采用 Wilcoxon 符号秩检验进行事后分析，并进行 Bonferroni 校正。采用 p 值为 0.00625 来确定统计学上的显著差异。Friedman 检验分析显示，从 T4-5 到 T11-12，平移运动、椎间盘高度和椎间盘退变均有显著差异（p<0.001）。T4-5 节段的平移运动最小，而 T10-11 节段的平移运动最大。下胸椎（T8-12）的平移运动、椎间盘退变程度和椎间盘高度明显大于上胸椎（T4-8，p<0.001）。T11-12 节段的椎间盘退变最严重。在上胸椎水平，椎间盘退变与平移运动之间存在显著负相关（p=0.013）。下胸椎（T8 以下）的平移运动、椎间盘退变程度和椎间盘高度明显更大。这些信息对于进一步了解胸椎脊柱运动学至关重要，并可能有助于确定涉及胸椎的融合手术的融合终点。
