The narrowing of the lumbar spinal canal during loaded MRI: the effects of the disc and ligamentum flavum
The narrowing of the lumbar spinal canal during loaded MRI: the effects of the disc and ligamentum flavum
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DOI：
10.1007/s00586-009-0919-7
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发表时间：
2009-05-01
影响因子：
2.8
通讯作者：
Gaulitz, Arne
中科院分区：
文献类型：
--
作者：
Hansson, Tommy;Suzuki, Nobuyuki;Gaulitz, Arne
脊柱负荷和活动度的变化通常会导致椎管狭窄患者的神经根受压症状。腰椎间盘突出症一直被认为是压迫的主要原因。目的是确定加载MRI时腰椎管大小的变化，特别是由黄韧带和椎间盘引起的变化。为此，对连续的患者进行了干预性临床研究。对24例仰卧位患者的腰椎进行了MRI检查：先不加任何外载荷，然后加相当于体重一半的轴向载荷。通过椎管横截面积、黄韧带横截面积、黄韧带厚度、椎体后凸度和椎间角来确定载荷的影响。外加负荷减小了椎管大小。50%至85%的椎管狭窄是由黄韧带膨大引起的。结论：在负荷性腰椎管狭窄中，黄韧带而不是间盘起主导作用，这一发现有助于提高对椎管狭窄的病理生理的认识。
Load and activity changes of the spine typically cause symptoms of nerve root compression in subjects with spinal stenosis. Protrusion of the intervertebral disc has been regarded as the main cause of the compression. The objective was to determine the changes in the size of the lumbar spinal canal and especially those caused by the ligamentum flavum and the disc during loaded MRI. For this purpose an interventional clinical study on consecutive patients was made. The lumbar spines in 24 supine patients were examined with MRI: first without any external load and then with an axial load corresponding to half the body weight. The effect of the load was determined through the cross-sectional areas of the spinal canal and the ligamentum flavum, the thickness of ligamentum flavum, the posterior bulge of the disc and the intervertebral angle. External load decreased the size of the spinal canal. Bulging of the ligamentum flavum contributed to between 50 and 85% of the spinal canal narrowing. It was concluded that the ligamentum flavum, not the disc had a dominating role for the load induced narrowing of the lumbar spinal canal, a finding that can improve the understanding of the patho-physiology in spinal stenosis.