CAJ | 학술논문

目的确定成人脊髓圆锥的位置,以避免腰麻穿刺时损伤脊髓.方法腰腿痛病人800例,年龄18～91岁,采用Siemens 1.5 T磁共振成像系统进行成像,正中矢状面上脊髓最远一点所对应的椎体或椎间盘为脊髓圆锥末端的位置.结果 190例病人脊髓圆锥末端位置位于L1.2间隙以下.随年龄段的增加,脊髓圆锥末端位于L1.2间隙以下的发生率升高(P＜0.05).结论常规临床采用L2,3间隙进行蛛网膜下腔穿刺时应慎重,建议腰麻病人术前应该作CT或MRI确定脊髓圆锥位置,以避免蛛网膜下腔穿刺时损伤脊髓.
목적 학정성인척수원추적위치,이피면요마천자시손상척수.방법 요퇴통병인800례,년령18～91세,채용Siemens 1.5 T자공진성상계통진행성상,정중시상면상척수최원일점소대응적추체혹추간반위척수원추말단적위치.결과 190례병인척수원추말단위치위우L1.2간극이하.수년령단적증가,척수원추말단위우L1.2간극이하적발생솔승고(P＜0.05).결론 상규림상채용L2,3간극진행주망막하강천자시응신중,건의요마병인술전응해작CT혹MRI학정척수원추위치,이피면주망막하강천자시손상척수.
Objective To investigate the variation in the position of conus medullaris in Chinese adult population in order to avoid hitting conus during spinal puncture. Methods Eight hundred patients suffering from back pain, aged 18-91 yr, were enrolled in this study. The position of conus medullaris was determined using Siemens 1.5 T magnetic resonance imaging system. According to the method described by Reimann, the vertebral body was used as mark of reference to the level of the end of conus. Results There were 190 patients in whom the position of the end of conus medullaris was lower than L1,2 . The incidence of the position of the end of conus medullaris lower than L1,2 was higher in patients 30-60 or older than in those under 30, and in those over the age of 60 than in those 30-60 (P ＜ 0.05). Conclusion Spinal puncture should be performed cautiously at L2,3. CT or MRI is recommended before operation for the patients to locate the position of conus medullaris and avoid injury to the spinal cord.