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胸腰椎交界处的椎体:使用 CT 扫描进行定量评估。

Vertebrae at the thoracolumbar junction: A quantitative assessment using CT scans.

机构信息

Department of Anatomy, Health Science Campus, University of Pretoria, Pretoria, South Africa.

Department Anatomy, School of Medicine, University of Namibia, Windhoek, Namibia.

出版信息

J Anat. 2022 Jun;240(6):1179-1186. doi: 10.1111/joa.13619. Epub 2021 Dec 27.

Abstract

The thoracolumbar junction is often associated with traumatic injuries, due to its biomechanical instability. Reasons for this instability are currently still under debate; however, contributing factors such as the rapid change in spinal curvature and facet orientation from the thoracic to lumbar transition have been implicated. Normally, the superior facet orientation in the thoracic region is angled in a coronal plane, whereas vertebrae in the lumbar region have facets angled in the sagittal plane. Distinguishing between thoracic, lumbar, and transitional vertebrae at the thoracolumbar junction based on articular facet angles, using quantitative methods on CT scans has, to the authors' knowledge, not yet been reported in the literature. Therefore, this study aimed to evaluate whether quantitative measurements can be clinically applied and used to differentiate vertebrae at the thoracolumbar junction using CT scans and, additionally, to record possible cases of congenital defects or variations observed in the spine. A sample (n = 173) of CT scans representative of the Windhoek population in Namibia was retrospectively assessed using radio-imaging software. Measurements of the angle formed by the superior facets of the vertebrae at the thoracolumbar junction (T11-L1) were recorded. Based on the results of this study, quantitative morphometry of the superior facet of vertebrae can differentiate between thoracic, lumbar,. and transitional vertebrae at the thoracolumbar junction. All individuals with identified thoracolumbar transitional vertebrae (TLTV) in this sample had at least one other congenital anomaly of the spine.

摘要

胸腰椎交界处常与创伤性损伤有关,这是由于其生物力学不稳定。目前,导致这种不稳定性的原因仍存在争议;然而,一些因素被认为是导致不稳定的原因,如从胸段到腰段过渡时脊柱曲率和小关节面方向的快速变化。通常,胸段的上关节面在冠状面上成角,而腰椎的关节面在矢状面上成角。据作者所知,目前尚未有文献报道使用 CT 扫描基于关节面角度对胸腰椎交界处的胸椎、腰椎和过渡性椎体进行定量区分。因此,本研究旨在评估定量测量是否可以临床应用,并用于通过 CT 扫描区分胸腰椎交界处的椎体,此外,还记录脊柱中观察到的可能的先天性缺陷或变异。使用放射影像学软件对代表纳米比亚温得和克人群的 CT 扫描样本(n=173)进行回顾性评估。记录胸腰椎交界处(T11-L1)椎体上关节面形成的角度的测量值。基于这项研究的结果,椎体上关节面的定量形态测量可以区分胸腰椎交界处的胸椎、腰椎和过渡性椎体。在本样本中,所有确定的胸腰椎过渡性椎体(TLTV)患者都至少有一个其他脊柱先天性异常。

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