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The Study of the Relationship between Variation of Lumbar Spine Bone Structure and Lumbar Disc Herniation

Author: XuHuaLiang
Tutor: WangHuan
School: China Medical University
Course: Surgery
Keywords: Lumbar disc herniation Bone structure CT
CLC: R681.5
Type: Master's thesis
Year: 2009
Downloads: 104
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Abstract


PrefaceLumbar disc herniation（Lumber Disc Herination,LDH）is one of the most common reason that lead to low back pain.The cause of Lumbar disc protrusion relate with age sex psychological genetic and anatomical factors.Facet joint asymmetry and bilateral lumbar muscle asymmetry,etc.are possible factors in Lumbar disc protrusion.The study of such as bone structure of lumbar vertebrae spinous process deviation,etc associated with lumbar disc herniation has been reported rarely.Lumbar disc herniation occurs most often at L4～L5 and L5～S1Therefore,this experiment mainly measurement and statistical analysis the CT data of L4 and L5 section vertebral body anatomy to study the variation of lumbar spine bone structure and the relevance of lumbar disc herniation.Materials and Methods1.Case selection and inclusion criteria2006 to 2008 lines in our hospital radiology in patients with lumbar spine CT examinations has 5286 cases,Screened 3277 cases of patients with standard sort code, 317 cases of lumbar disc were randomly selected from them for the case group,183 cases of lumbar intervertebral disc un protrusion were randomly selected for the control group,the total was 500 cases,of which 242 cases of men,258 cases of women,age range 15～81 years old.CT are the PQ2000 spiral CT machine and Marconi MX8000 multi-slice spiral CT machine.PACS system（Picture Archiving Communication System） is used to store and measure CT data.Choose under 3mm axial of L4 and L5 vertebral endplate to measure each parameter.2.The contents of investigation and measurement of targetRecord age,gender and measure the collection of the following indicators:（1）Spinous process angle（2）Intervertebral disc height and lumbar intervertebral disc height the share ratio of the whole intervertebral discs（3）longitudinal diameter of Intraspinal,longitudinal diameter of vertebral body, transverse diameter of vertebral body（4）thickness of ligamenta flava（5）cross-sectional area of Intraspinal,cross-sectional area of vertebral body（6）Lamina angle（7）Lamina length（8）Lamina thickness（9）the longitudinal length of axis Vertebra facet;（10）Lumbosacral angle（11）distance of two small intra-articular3.Statistical analysisSet up the database.SPSS 12.0 sofeware was employed to analyze all data.Staistical evaluation was performed using chi-square test,etc and correlation analysis.Statistics significance level wasα=0.05.Results1.Spinous process deflection angle of Lumbar disc herniation group were compared with the control group.Process deflection angle at L4,L5 levels had a significant statistical difference （P＜0.01） between the high EHT and the control.The data showed normal distribution. Using rank sum test,it had a significant statistical differnect（P＜0.01）. 2.At L4 level,comparing each measurement target of male in prominent group and control group.The analysis show that there was significant statistical difference（P＜0.01） in the L4 intervertebral disc height,the share ratio of the whole intervertebral discs,Lamina length,Lamina thickness,distance of two small intra-articular,longitudinal diameter of Intraspinal,the ratio of longitudinal diameter and vertebral body diameter,area of vertical spinal muscular between prominent group and control group,there was statistical difference（P＜0.05） in the left thickness of ligamenta flava,the longitudinal length of axis Vertebra facet between prominent group and control group.3.At L4 level,comparing each measurement target of female in prominent group and control group.Comparing each measurement target of femalea at L4 level in prominent group and control group,the analysis show that there was significant statistical difference（P＜0.01） in the Lumbosacral angle,Lamina length,Lamina thickness,the longitudinal length of axis Vertebra facet,distance of two small intra-articular,longitudinal diameter of Intraspinal,the ratio of longitudinal diameter and vertebral body diameter,thickness of ligamenta flava between prominent group and control group,there was statistical difference（P＜0.05） in the share ratio of the L4 intervertebral disc height in the whole intervertebral discs between prominent group and control group.4.At L5 level,comparing each measurement target of male in prominent group and control group.The analysis show that there was significant statistical difference（P＜0.01） in the L5 intervertebral disc height,the share ratio of the whole intervertebral discs, longitudinal diameter of Intraspinal,the ratio of longitudinal diameter and vertebral body diameter,thickness of ligamenta flava between prominent group and control group.There was statistical difference（P＜0.05） in the transverse diameter of vertebral body between prominent group and control group.5.At L5 level,comparing each measurement target of female in prominent group and control group.Comparing each measurement target of femalea at L5 level in prominent group and control group,the analysis show that there was significant statistical difference（P＜0.01） in the Lumbosacral angle,the share ratio of the L5 intervertebral disc height in the whole intervertebral discs,lamina length,lift lamina thickness,distance of two small intra-articular,longitudinal diameter of Intraspinal,transverse diameter of vertebral body,the ratio of longitudinal diameter and vertebral body diameter,thickness of ligamenta flava,area of vertical spinal muscular between prominent group and control group,there was statistical difference（P＜0.05） in the height of L4 intervertebral disc, right lamia thickness,ratio of longitudinal diameter and transverse diameter of vertebral body between prominent group and control group.ConclusionThis study show that the spinous process deviation is the risk factors of lumbar disc herniation.increasing of womens lumbosacral angle is the risk factors of lumbar disc herniation of.

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CLC: > Medicine, health > Surgery > Orthopaedic Surgery ( movement system diseases,orthopedic surgery ) > Bone diseases > Spine and back disorders
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