Chen D, Fay L A, Lok J, Yuan P, Edwards W T, Yuan H A
Department of Orthopedic Surgery, SUNY Health Science Center, Syracuse.
Spine (Phila Pa 1976). 1995 Jan 1;20(1):74-9. doi: 10.1097/00007632-199501000-00014.
This study quantified changes in the size of the stenotic neuroforamen in degenerative lumbar spines. The volume and area of the neuroforamen were measured before and after the application of anterior distraction using the BAK interbody fusion system.
To quantitatively assess the neuroforaminal area and volume when the BAK interbody fusion system is applied to lumbar spines with neuroforaminal stenosis.
The spatial relationship between the nerve root and the osseous and nonosseous elements of the neuroforamen is clinically important. Few studies have focused on changes in neuroforaminal size in the lumbar spine after anterior interbody distraction. No previous study has assessed the neuroforaminal volume.
The BAK instrumentation system was applied anteriorly at L4-L5 and L5-S1 intervertebral discs in nine degenerative cadaver lumbar spines. The neuroforaminal volumes of L4-L5 and L5-S1 were measured from silicon molds taken of the neuroforamen. In addition, computed tomography and circular blunt probes were used to determine the neuroforaminal areas. The disc height was recorded from lateral radiographs.
After the BAK instrumentation, the volume of the neuroforamen increased significantly--by 22.9% for L4-L5 and 21.5% for L5-S1. The posterior disc height increased by 37.1% at L4-L5 and 45.1% at L5-S1. The neuroforaminal areas significantly increased--by 29.0% at L4-L5 and 33.8% at L5-S1. There was good correlation between the volume and the posterior disc height (R2 = 0.50) and the volume and the area of the narrowest portion of neuroforamen (R2 = 0.56).
The results indicated that anterior systems such as the BAK system, which increase disc heights, can significantly increase neuroforaminal volume and area, providing adequate space for the nerve root and improving neuroforaminal stenosis.
本研究对退行性腰椎狭窄神经孔大小的变化进行了量化。使用BAK椎间融合系统进行前路撑开前后，测量了神经孔的体积和面积。
定量评估将BAK椎间融合系统应用于伴有神经孔狭窄的腰椎时神经孔的面积和体积。
神经根与神经孔的骨性和非骨性结构之间的空间关系具有重要临床意义。很少有研究关注腰椎前路椎间撑开后神经孔大小的变化。此前尚无研究评估神经孔体积。
在9具退行性尸体腰椎的L4-L5和L5-S1椎间盘前方应用BAK内固定系统。从神经孔的硅铸模中测量L4-L5和L5-S1的神经孔体积。此外，使用计算机断层扫描和圆形钝头探针确定神经孔面积。从侧位X线片记录椎间盘高度。
应用BAK内固定系统后，神经孔体积显著增加——L4-L5增加22.9%，L5-S1增加21.5%。L4-L5椎间盘后高度增加37.1%，L5-S1增加45.1%。神经孔面积显著增加——L4-L5增加29.0%，L5-S1增加33.8%。体积与椎间盘后高度之间（R2 = 0.50）以及体积与神经孔最窄处面积之间（R2 = 0.56）存在良好的相关性。
结果表明，像BAK系统这样能增加椎间盘高度的前路系统，可显著增加神经孔体积和面积，为神经根提供足够空间并改善神经孔狭窄。
