In Vivo Characteristics of Nondegenerated Adjacent Segment Intervertebral Foramina in Patients With Degenerative Disc Disease During Flexion-Extension.
In Vivo Characteristics of Nondegenerated Adjacent Segment Intervertebral Foramina in Patients With Degenerative Disc Disease During Flexion-Extension.
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DOI：
10.1097/brs.0000000000001758
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发表时间：
2017-03-15
期刊：
影响因子：
3
通讯作者：
Li G
中科院分区：
文献类型：
--
作者：
Cha TD;Moore G;Liow MHL;Zhong W;Wu M;Wang S;Kang JD;Wood KB;Li G
体内患者生物力学研究。研究退行性椎间盘疾病（DDD）患者在身体屈伸运动期间腰椎间孔（LIVF）的尺寸。 LIVF 狭窄可能会导致神经根受压。 DDD 患者在生理负荷条件下退化和邻近非退化 LIVF 的面积变化尚不清楚。招募了 9 名有 L4-S1 DDD 放射学证据的有症状的腰痛患者。对每位受试者进行 MRI 扫描，以构建 3D 腰椎模型，并在身体从 45° 屈曲伸展到完全伸展时进行荧光镜成像，以重建 LIVF 尺寸。将邻近节段L3/4以及病变节段L4/5和L5/S1在身体45°屈曲、直立和完全伸展时与正常对照组进行比较。 DDD节段的平均LIVF面积在所有位置均显着小于正常受试者（p<0.05）。在直立位时，DDD患者的LIVF面积L4/5和L5/S1分别比正常受试者小32.8%和33.6%。对于邻近的 L3/4，DDD 患者的 LIVF 面积比正常对照小 32.3%（p<0.05）。 DDD患者从屈曲到伸展时L3/4 LIVF面积的总变化明显小于正常受试者，但两组之间L4/5和L5/S1 LIVF面积的变化相似(p>0.05)。在 DDD 患者的邻近节段和受累节段观察到 LIVF 尺寸的类似减小，这意味着尽管缺乏退化的放射学证据，但邻近节段可能已经发生了生物力学变化。后续研究应重点关注手术融合对邻近节段生物力学特征的影响。不适用
In vivo patient biomechanical study. To investigate the dimensions of lumbar intervertebral foramen (LIVF) of patients with degenerative disc disease (DDD) during a flexion-extension motion of the body. LIVF narrowing may result in nerve root compression. The area changes of degenerated and adjacent non-degenerated LIVFs in DDD patients under physiologic loading conditions are unknown. Nine symptomatic low back pain patients with radiological evidence of L4-S1 DDD were recruited. Each subject was MRI scanned for construction of 3D lumbar vertebral models, and fluoroscopically imaged when the body extended from 45° flexion to full extension for reconstruction of LIVF dimensions. The data of the adjacent segment L3/4 and diseased segment L4/5 and L5/S1 were compared with a normal control group at 45° flexion, upright, and full extension of the body. The mean LIVF areas of DDD segments were significantly smaller than those of the normal subjects in all positions (p<0.05). In upright position, the LIVF areas of the DDD patients were 32.8% and 33.6% smaller than the normal subjects for L4/5 and L5/S1, respectively. For the adjacent L3/4, the LIVF area of the DDD patients was 32.3% smaller than that of the normal controls (p<0.05). The total change of L3/4 LIVF area in DDD patients from flexion to extension was significantly smaller than that of the normal subjects, but the changes in L4/5 and L5/S1 LIVF areas were similar between the two groups (p>0.05). Similar reductions of the LIVF dimensions were observed at the adjacent and the involved levels of the DDD patients, implying that biomechanical changes might have already occurred at the adjacent segment despite the lack of radiographic evidence of degeneration. Subsequent research should focus on the effects of surgical fusion on the biomechanical features of the adjacent segment. N/A