Chaimongkhol Thawanthorn, Thiamkaew Atiphoom, Mahakkanukrauh Pasuk
Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Anat Cell Biol. 2019 Jun;52(2):143-148. doi: 10.5115/acb.2019.52.2.143. Epub 2019 Jun 30.
Spinal stenosis most commonly occurs on lumbar vertebrae because of degenerative changes. This research studied the characteristics of osteophyte development in lumbar vertebrae foramina and association of osteophyte development with lumbar spinal stenosis. The total number of all levels of lumbar spines of subjects was 179 from 31 to 90 years of age. The vertebral foramen was divided into six zones. The prevalence and measurements of the length of osteophytes in the vertebral foramina were obtained. The prevalence and length of osteophytes in the posterior body zone were higher than the laminal zone, and higher than the pedicular zone, respectively. In each zone, the highest prevalence of osteophytes was at L5, except for the inferior posterior body zone that the highest prevalence is at L4. The length of osteophyte was also in same direction as the prevalence. The prevalence of osteophytes among six zones of each level were compared, and found, in L1 to L4, the inferior posterior body zone generally had the highest prevalence, except in L5, the superior posterior body zone had the highest prevalence. Moreover, prevalence, as well as length, of osteophytes in lumbar vertebral foramina, of all levels, was positively associated with age. Vertebral osteophytes can develop beginning at 31 years of age. In conclusion, posterior body of L4 and L5 had the highest prevalence of osteophyte formation, thus, these area had the highest probability to cause spinal stenosis.
由于退行性改变,椎管狭窄最常发生于腰椎。本研究探讨了腰椎椎间孔骨赘形成的特征以及骨赘形成与腰椎管狭窄的关系。研究对象为年龄在31至90岁之间的179个腰椎节段。椎间孔被分为六个区域。记录了椎间孔内骨赘的发生率及长度。椎体后缘区域骨赘的发生率和长度分别高于椎板区域和椎弓根区域。在每个区域中,除椎体后下缘区域骨赘发生率最高在L4外,其余区域骨赘发生率最高均在L5。骨赘长度的变化趋势与发生率一致。比较了每个节段六个区域的骨赘发生率,发现L1至L4节段中,椎体后下缘区域骨赘发生率通常最高,而L5节段中,椎体后上缘区域骨赘发生率最高。此外,各节段腰椎椎间孔内骨赘的发生率及长度均与年龄呈正相关。椎体骨赘从31岁开始出现。总之,L4和L5椎体后缘骨赘形成的发生率最高,因此这些部位导致椎管狭窄的可能性最大。