CT, MR AND CRYOMICROTOMIC STUDY OF SPINE ANATOMY

虽然3500万美国人患有背痛，但CT和MR是有效的 仅诊断了一小部分背痛和坐骨神经痛的病例。 椎间盘和小关节的疼痛状况，以及一些 中央和侧椎管狭窄可能被低估， 常规CT、MR和放射学研究。 本项目的目的是 通过以下方法提高CT和MR的诊断价值： 精确的解剖学/断层扫描相关性。 相关性有 确定的迹象表明，各种缺陷的纤维环，核 髓、黄韧带和小关节可以用 层析成像 迄今为止最有价值的贡献， 根据以前的评论，是使用生物力学技术， 模拟椎管和神经孔的变化， 正常活动可能产生的载荷和应力。 的 这项研究假设是中央和侧面椎管狭窄是 在CT和MR中被低估了，因为患者在检查过程中是躺着的。 图像的获取。 我们在模型扩展的更新中提出， 尸体脊柱的屈曲、侧弯和旋转 标本 将使用生物力学技术对 模拟脊柱的运动，将测量位移 与运动学技术，和解剖关系的变化， 椎间盘、小关节、黄韧带、经椎间孔韧带，以及 神经根将通过CT、MR和冷冻切片术进行研究。 的 载荷和位移以及导致脊柱 将识别狭窄。 这项研究可能会提供信息， 神经根病的病因 除了在我们的研究中， 神经管和神经孔，经孔韧带，减少了 脊柱神经的可用空间，已被忽略。 具体来说，神经孔和脊柱的病理解剖变化 管道将被确定，其中应力，如直立位置， 负重和其他活动可能会严重缩小神经 或影响脊神经。

While 35 million Americans suffer from back pain, CT and MR are effective in diagnosing only a fraction of cases of back pain and sciatica. Painful conditions of the disc and facet joints, and some cases of central and lateral spinal stenosis are likely underdiagnosed by conventional CT, MR and radiographic studies. The aims of this project have been to improve the diagnostic usefulness of CT and MR by means of precise anatomic/tomographic correlations. The correlations have identified signs by which various defects in the anulus fibrous, nucleus pulposus, ligamentum flavum and facet joints can be demonstrated with tomographic imaging. The most valuable contribution of the work to date, according to previous reviews, was the use of biomechanical techniques to model the changes produced in the spinal canal and neural foramina by loads and stresses that may be produced by normal activities. The hypothesis of this study is that central and lateral spinal stenosis are underestimated in CT and MR because patients are recumbent during the acquisition of the images. We propose in the renewal to model extension, flexion, lateral bending and rotation of the spine in cadaveric specimens. Loads will be applied with biomechanical techniques to the spine to simulate movement of the spine, displacements will be measured with kinematic techniques, and changes in anatomic relationships of the discs, facet joints, ligamentum flavum, transforaminal ligaments, and nerve roots will be studied by means of CT, MR, and cryomicrotomy. The loads and displacements and anatomic situations which result in spinal stenosis will be identified. The study is likely to provide information on the causes of radiculopathy. Except in our studies of the spinal canal and neural foramen, the transforaminal ligaments, which reduce the space available for the spinal nerves, have been disregarded. Specifically, patho-anatomic changes in the neural foramina and spinal canal will be identified in which stresses such as upright position, weight bearing, and other activities may critically narrow the neural foramina or affect spinal nerves.