CT, MR AND CRYOMICROTOMIC STUDY OF SPINE ANATOMY

尽管有3500万美国人背部疼痛，但CT和MR是有效的 在诊断背痛和坐骨神经痛的病例中只有一小部分。 关节盘和小关节的疼痛状况，以及一些病例 中央型和侧型椎管狭窄可能被低估 常规CT、MR和X线片检查。这个项目的目标是 一直致力于通过以下方法提高CT和MR的诊断有用性 精确的解剖/断层对比。它们之间的关联性 识别出纤维环、核的各种缺陷的征象 牙髓、黄韧带和小关节可通过 断层成像。到目前为止，这项工作最有价值的贡献， 根据以前的综述，使用生物力学技术来 建立椎管和神经孔改变的模型 正常活动可能产生的载荷和应力。这个 这项研究的假设是中央和侧方椎管狭窄 在CT和MR中被低估了，因为患者在治疗过程中是卧位的 图像的采集。我们建议在更新到模型扩展， 身体脊柱的屈曲、侧弯和旋转 标本。加载将通过生物力学技术应用于 脊椎要模拟脊椎的运动，将测量位移 运动学技术，以及关节解剖关系的变化 关节盘、小关节、黄韧带、经孔韧带和 神经根将通过CT、MR和冷冻显微切割术进行研究。这个 导致脊柱的负荷和移位以及解剖情况 狭窄会被识别出来。这项研究可能会提供信息 关于神经根病的原因。除了我们对脊椎的研究 神经管和神经孔，即经孔韧带，它减少了 可供脊神经使用的空间已被忽视。 具体地说，神经孔和脊柱的病理解剖变化 将确定渠道中的应力，如竖直位置， 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.