中华解剖与临床杂志
中華解剖與臨床雜誌
중화해부여림상잡지
Chinese Journal of Anatomy and Clinics
2014年
2期
93-96
,共4页
夏天%王前%董双海%田纪伟
夏天%王前%董雙海%田紀偉
하천%왕전%동쌍해%전기위
腰椎%肌间隙%磁共振成像
腰椎%肌間隙%磁共振成像
요추%기간극%자공진성상
Lumbar spine%Intermuscular cleavage%Magnetic resonance imaging
目的 应用MRI测量腰椎各椎间盘平面多裂肌-最长肌间隙入口与中线的距离,并分析其相关因素.方法 前瞻性选取2012年4月-2013年1月行腰椎MRI检查的200例患者,测量腰椎MRI各椎间盘平面双侧肌间隙入口与中线的距离(D),并采用单因素方差分析和q检验比较节段间差异,t检验比较左右两侧及不同性别的差异,Pearson相关性检验分析各节段D间的相关性,多元线性回归分析各节段D与患者年龄、身高、BMI的相关性.结果 腰椎各椎间盘平面肌间D从L1/2水平至L5/S1水平逐渐增大,不同节段间D差异有统计学意义(左侧:F=3614.84,P=0.00;右侧:F=3 411.34,P=0.00),但左右侧间差异无统计学意义(P＞0.05),D1仅与D2间存在相关性,而D2～D5间则两两正相关.男性与女性患者仅L4/5节段D差异有统计学意义(t=4.44,P＜0.01),其他节段D男女间差异均无统计学意义(P值均＞0.05).各节段D与患者的年龄均无相关性.男性患者D1双侧均与身高呈正相关,女性患者D1L、D1R及D2L与BMI正相关,而D4双侧与身高呈正相关.结论 腰椎多裂肌-最长肌间隙入口位置与患者年龄、性别、身高、BMI等关系不大.在L1-3水平,肌间隙距离正中线较近,适合作单个正中切口;在L4～S1水平则应根据术前测量结果应用双侧切口.
目的 應用MRI測量腰椎各椎間盤平麵多裂肌-最長肌間隙入口與中線的距離,併分析其相關因素.方法 前瞻性選取2012年4月-2013年1月行腰椎MRI檢查的200例患者,測量腰椎MRI各椎間盤平麵雙側肌間隙入口與中線的距離(D),併採用單因素方差分析和q檢驗比較節段間差異,t檢驗比較左右兩側及不同性彆的差異,Pearson相關性檢驗分析各節段D間的相關性,多元線性迴歸分析各節段D與患者年齡、身高、BMI的相關性.結果 腰椎各椎間盤平麵肌間D從L1/2水平至L5/S1水平逐漸增大,不同節段間D差異有統計學意義(左側:F=3614.84,P=0.00;右側:F=3 411.34,P=0.00),但左右側間差異無統計學意義(P＞0.05),D1僅與D2間存在相關性,而D2～D5間則兩兩正相關.男性與女性患者僅L4/5節段D差異有統計學意義(t=4.44,P＜0.01),其他節段D男女間差異均無統計學意義(P值均＞0.05).各節段D與患者的年齡均無相關性.男性患者D1雙側均與身高呈正相關,女性患者D1L、D1R及D2L與BMI正相關,而D4雙側與身高呈正相關.結論 腰椎多裂肌-最長肌間隙入口位置與患者年齡、性彆、身高、BMI等關繫不大.在L1-3水平,肌間隙距離正中線較近,適閤作單箇正中切口;在L4～S1水平則應根據術前測量結果應用雙側切口.
목적 응용MRI측량요추각추간반평면다렬기-최장기간극입구여중선적거리,병분석기상관인소.방법 전첨성선취2012년4월-2013년1월행요추MRI검사적200례환자,측량요추MRI각추간반평면쌍측기간극입구여중선적거리(D),병채용단인소방차분석화q검험비교절단간차이,t검험비교좌우량측급불동성별적차이,Pearson상관성검험분석각절단D간적상관성,다원선성회귀분석각절단D여환자년령、신고、BMI적상관성.결과 요추각추간반평면기간D종L1/2수평지L5/S1수평축점증대,불동절단간D차이유통계학의의(좌측:F=3614.84,P=0.00;우측:F=3 411.34,P=0.00),단좌우측간차이무통계학의의(P＞0.05),D1부여D2간존재상관성,이D2～D5간칙량량정상관.남성여녀성환자부L4/5절단D차이유통계학의의(t=4.44,P＜0.01),기타절단D남녀간차이균무통계학의의(P치균＞0.05).각절단D여환자적년령균무상관성.남성환자D1쌍측균여신고정정상관,녀성환자D1L、D1R급D2L여BMI정상관,이D4쌍측여신고정정상관.결론 요추다렬기-최장기간극입구위치여환자년령、성별、신고、BMI등관계불대.재L1-3수평,기간극거리정중선교근,괄합작단개정중절구;재L4～S1수평칙응근거술전측량결과응용쌍측절구.
Objective To measure the distances from the intermuscular cleavage to the midline at each intervetebral disc level by MRI,and to analyze the related factors.Methods MRI scans of 200 patients taken during routine care (2012.04-2013.01) were retrospectively reviewed.The distances (D) from the intermuscular cleavage planes to the midline,bilaterally,at each disc level were measured.Oneway analysis of variance (ANOVA) and q test were used to compare the difference between the Ds of each intervertebral disc level.Paired t-test and independent t-test were used to compare Ds of different sides and genders.Pearson correlation test was used to analyze the correlation between the Ds of each intervertebral disc level.Multi-linear regression analysis was used to analyze the correlation between the D of each intervertebral disc level and the age,height,and body mass index (BMI).Results The mean measurements of D increase from L1/2 to L5/S1,and significantly different between all disc levels (lefi side:F =3 614.84,P =0.00; right side:F =3 411.34,P =0.00),but the Ds in left side did not significantly differed from that in right side.Ds only differed in L4/5 disc level between males and females (t =4.44,P ＜ 0.01),while no significant difference was found in the other levels (all P values ＞ 0.05).No correlation was discovered between ages with respect to measured distances.D1 positively correlated with height in males bilaterally.As in females,positive correlations were discovered between D1L,D1R,D2L and BMI,and bilateral D4 and height.Conclusions Little correlations are discovered between age,gender,BMI or height with respect to measured distances.In the upper levels of the lumbar spine (L1-3),it prefers approaching through a single midline incision,because of the small distance.In the lower levels of the lumbar spine (L4-S1),it prefers dual-incision paraspinal approach with preoperative localization via images of MRI or CT.
