胸腰椎压缩骨折过伸复位枕弧面放射学参数的测定

发布时间：2018-06-12 17:08

本文选题：胸腰椎压缩性骨折 + 复位枕　；参考：《广州中医药大学》2013年硕士论文

【摘要】：目的：通过测量健康成年人脊柱胸腰段过伸位弧度的相关放射学指标数值,为胸腰椎骨折复位枕弧面的研制提供具有临床意义的观测指标和参考数值,从而为胸腰椎压缩性骨折复位提供符合中国成年人解剖形态的确切优化的依据和方法。方法：收集健康志愿者100例,经放射学检查确诊无脊柱相关骨科疾病,最后纳入研究70例,其中女性37例,男性33例,年龄18-70岁,平均年龄43.5±14.6岁,身高分布从150-180厘米。以平卧过伸位时(腰部垫充气枕,基础高度5厘米)常规胸腰段脊柱侧位x线摄片。分别测量平卧过伸位时常规胸腰段脊柱侧位x线摄片下T1o-L5各个椎体棘突末端离床面垂直高度、T10～L5各椎体棘突间水平距离。统计分析健康人在平卧过伸状态下T1o-L5各个椎体棘突末端离床垂直高度、T10～L5水平总长度与性别、年龄之间的关系。所有数据采用SPSS17.0进行统计学分析,将志愿者按年龄及性别两种分组方法,18-40岁为青年组,41-70为中老年组,男性及女性各分为两组。两组间测量数值变化采用两独立样本t检验,计量资料以均数±标准差(x±S)表示,检验数据的正态性分布和方差齐性,符合正态分布和方差齐的数据使用t检验,不符合者则使用近似t检验(即t’检验),α=0.05,P0.05时为有统计学意义。结果：所测结果均符合或接近正态分布。根据计算机软件计算的数据T1o棘突距离床面高度为28.07±6.52毫米,T11为37.38±7.71毫米,T12为46.87±8.46毫米,L1为56.43±8.08毫米,L2为64.65±7.77毫米,L3为67.65±7.62毫米,L4为68.46±7.94毫米；T10-L5水平总长度为197.76±12.06毫米,T10-L5各椎体棘突间距分别为：T1o-T11为22.99±3.07毫米,T11-T12为24.91±2.74毫米,T12-L1为27.71±3.46毫米,L1～L2为32.67±3.04毫米,L2-L3为33.15±2.06毫米,L3-L4为32.33±2.51毫米,L4-L5为23.984±2.57毫米。经统计学分析证实各椎体离床面垂直距离测得的数据在性别之间比较无统计学意义,在年龄分组方面青年组与中老年组相比较无统计学意义(P0.05),T10～L5水平总长度在性别之间比较有统计学意义(P0.05),在不同年龄分组之间比较无统计学意义(P0.05)。结论：经放射学测量,胸腰椎过伸位弧度是从胸8～骶4的、以腰4棘突为顶点(高度约7厘米)的非对称弧形。弧形高度在不同性别个体之间及不同年龄之间比较,差异无统计学意义,复位枕头水平长度在不同性别间比较有统计学意义。胸腰椎压缩性骨折的复位枕面的弧度应根据此参数制作。
[Abstract]:Objective: to provide clinical observation and reference values for the development of thoracolumbar fracture reduction occipital arc by measuring the radiologic indexes of thoracolumbar extension position in healthy adults. Thus, the reduction of thoracolumbar compression fracture can be optimized in accordance with the anatomical morphology of adults in China. Methods: a total of 100 healthy volunteers were included in the study, including 37 females and 33 males, aged 18-70 years, with an average age of 43.5 卤14.6 years. Height ranges from 150 to 180 cm. X-ray radiographs of lateral thoracolumbar spine were performed in supine position (5 cm base height with inflatable pillow on the waist cushion). The horizontal distance between spinous process and spinous process of T10 and L5 vertebrae were measured at the vertical height of the end of each spinous process of T _ 1o-L _ 5 in the lateral position of thoracolumbar spine in supine and extensional position. The relationship between the total length of T _ (10) T _ (10) L _ (5) level and the sex and age of healthy persons was analyzed statistically under the condition of supine overstretching of T1o-L5 and the vertical height of the end of the spinous process of each vertebral body from the bed. All the data were analyzed by SPSS 17.0. According to age and sex, the volunteers were divided into two groups: male group and female group. Two independent samples t test were used to measure the numerical changes between the two groups. The measured data were expressed as mean 卤standard deviation (x 卤S). The normal distribution and variance homogeneity of the test data were measured. The data with normal distribution and uniform variance were tested by t test. The nonconformities were tested by approximate t test (t 'test), and there was statistical significance when 伪 0. 05% (P 0.05). Results: all the results were in accordance with or close to normal distribution. The height of T1o spinous process from bed surface was 28.07 卤6.52 mm and T11 was 37.38 卤7.71 mm and T12 was 46.87 卤8.46 mm / L ~ (-1), 56.43 卤8.08 mm / L ~ (2), 64.65 卤7.77 mm / L ~ (3) and 67.65 卤7.62 mm / L _ (4) and 68.46 卤7.94 mm, respectively. The total length of T10-L5 level was 197.76 卤12.06 mm and the spinous process spacing of T10-L5 was: T1o-T11 22.99 卤3.07 mm, T11-T12 24.91 卤2.74 mm, T12-L1 27.71 卤3.46 mm, L1-L2 32.67 卤3.04 mm L2-L3 33.15 卤2.06 mm L3-L4 32.33 卤2.51 mm L4-L5 23.984 卤2.57 mm. The data measured from the vertical distance from the bed surface of the vertebrae were not statistically significant between the sexes by statistical analysis. In terms of age group, there was no significant difference between the young group and the middle and old age group. The total length of T10 L5 level in the young group was significantly higher than that in the middle and old age group (P 0.05), but there was no significant difference between the two groups. Conclusion: radiographically, the radiographic radiometry of the thoracolumbar vertebrae is from 8 to 4 of the thoracic spine, with the lumbar 4 spinous process as the apex (about 7 cm in height). There was no significant difference in arc height between individuals of different genders and between different ages, but the horizontal length of reset pillow was statistically significant compared with that of different genders. The radians of the reduction occipital surface of thoracolumbar vertebral compression fracture should be made according to this parameter.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R816.8

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