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基于计算机断层扫描的单一腰椎运动节段L4-5十年期形态测量

Decade-Wise Computed Tomography-Based Morphometric Measurements of a Single Lumbar Spinal Motion Segment L4-5.

作者信息

Kulkarni Arvind G, Ruparel Sameer, Jaggi Sunila, Murkey Nihkil

机构信息

Bombay Hospital and Medical Research Center, Mumbai, Maharashtra, India.

出版信息

Int J Spine Surg. 2020 Oct;14(5):795-803. doi: 10.14444/7113. Epub 2020 Oct 23.

Abstract

BACKGROUND

A spinal motion segment comprises facet joints and intervertebral disc. A complex interplay of biomechanical factors occurs between them with degeneration giving rise to numerous pathological conditions. We conducted a study to find a correlation between facet joint orientation and intervertebral discs with age.

METHODS

A cross-sectional study of 203 consecutive subjects undergoing a computed tomography scan of abdomen and pelvis were included. Subjects were divided into 5 groups based on age (group I: 18-30 years; group II: 31-40 years; group III: 41-50 years; group IV: 51-60 years; group V: 61-70 years). Using 3-dimensional reconstruction images, orientation of lumbar facet joints at the L4-5 level was measured. Similarly, adjacent disc heights at L3-4 and L4-5 were measured and their ratio was documented.

RESULTS

The study included 106 males and 97 females. A positive correlation was noted between age and sagittal facet orientation until age 60 years. However, after age 60 years, a negative correlation with age was seen, which was statistically significant. Similarly, the disc height ratios show a progressive decline in their values with age. However, this decline was statistically significant only after age 60 years.

CONCLUSION

The gradual change of facet joint orientation from sagittal to coronal as the age crosses from 30 to 60, to beyond 60, with a simultaneous and parallel diminishing in the disc height probably is one of the attributes of the phenomenon of autostabilization of a motion segment.

摘要

背景

脊柱运动节段由小关节和椎间盘组成。它们之间存在生物力学因素的复杂相互作用,退变会引发多种病理状况。我们开展了一项研究,以探寻小关节方向与椎间盘随年龄变化的相关性。

方法

纳入203例连续接受腹部和骨盆计算机断层扫描的受试者进行横断面研究。根据年龄将受试者分为5组(I组:18 - 30岁;II组:31 - 40岁;III组:41 - 50岁;IV组:51 - 60岁;V组:61 - 70岁)。利用三维重建图像,测量L4 - 5水平腰椎小关节的方向。同样,测量L3 - 4和L4 - 5相邻椎间盘高度并记录其比值。

结果

该研究包括106例男性和97例女性。在60岁之前,年龄与矢状面小关节方向呈正相关。然而,60岁之后,与年龄呈负相关,且具有统计学意义。同样,椎间盘高度比值随年龄增长逐渐下降。然而,这种下降仅在60岁之后具有统计学意义。

结论

随着年龄从30岁跨越到60岁再到60岁以上,小关节方向从矢状面逐渐变为冠状面,同时椎间盘高度同步且平行减小,这可能是运动节段自动稳定现象的特征之一。

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