The Lumbar X-ray Film Measurement Of Healthy Middle-aged And Elderly People In Xi'an

ObjectiveThe lumbar X-ray films from 200 healthy middle-aged and elderly people in Xi'an, China were measured and compared to add data of lumbar vertebrae to Chinese people, and to provide clinical reference of anatomic parameters for the diagnosis and surgery treatment of lumbar vertebrae.Method①Two hundred people in Xi'an, 100 male and 100 female, aged from 45 to 72, averaged 56.1 years, were selected in the manner of stratification, classification and cluster random sampling.②After lumbar anterior lateral X-ray was taken, the film were recorded and input into computer digitally and the following parameters were measured by Auto CAD software: 1.length of pedicle screw channel; 2.sagittal diameter of pedicle; 3.transverse diameter of pedicle; 4.height of intervertebral space; 5.lumbar curvature; 6 sagittal diameter of lumbar spine canal, and sacrum slant angle. At the same time, all measured data were analyzed statistically and compared with data from China and abroad.③Exclusion criteria: 1.any malformation of lumbar vertebra;2.any with osteoarthritis;3. any with obvious malformation in lumbar vertebral body, vertebral joints; 4.any with trauma, fracture of lumbar vertebra, dislocation, degenerative diseases and cancer in X-ray; 5.either lumbar sacralization or lumbarization.④Data among groups were compared statistically using Group Statistics Test; and those between two groups using the Independent Samples Test, taking 95% as confidence interval, and P <0.05 was statistically significant. The SPSS (16.0) analytical software was used, and all the data were compared statistically with T-test.ResultsLength of pedicle screw channel were of L1 through L5 ranged 43.18 to 45.67 mm in the male, and 38.49 to 40.87 in the female. The left sagittal diameter of pedicle in L1 through L5 were 10.06 to 12.68 mm in the male and 8.35 to 10.72mm in the female, while those in the right were 10.31 to 12.97mm in the male and 8.85 to 10.70mm in the female indicating that the height of vertebral pedicle of L₁ through L5 in the left (p<0.05) and those of L1 through L4 (P <0.05) have significant differences,while in the right that of L5 has no significant differencesbetween male and female (P> 0.05).The transverse diameter of L1-L5 pedicle in the left were 5.99 to 8.86mm in the male and 4.88 to 7.52mm in the female, and those in the right were 5.83 to 9.40mm in the male and 4.88 to 7.62mm in the female, showing significant differences between male and female in both the right and left. The anterior height of the intervertebral space in L_1-2 to L5 S1 were 9.05 to 14.60mm in the male and 7.80 to 13.59mm in the female,and the middle intervertebral space were 6.75 to 10.70mm in the male and 6.41 to 10.18mm in the female, the posterior intervertebral space were 4.79 to 6.36mm in the maleand 5.19 to 6.90mm in the female, with L_4/5 the highest in both men and women, and significant difference (P<0.05) among the anterior of L_1/2 , the anterior and the middle of L_2/3 ,L_3/4 and L₅S1 intervertebral space, and with no significant difference(P>0.05)among the anterior of L_4/5 , the middle of L_1/2 and L4/5, and the posterior of L_1/2 to L5S1 intervertebral space. Lumbar curvature were 11.94±4.58mm in the male and 10.85±5.27mm in the female with no significant differences between male and female (P>0.05). Sagittal diameter of lumbar spine canal in L1through L5 were 17.78 to 19.63mm in the male and 18.44 to 19.97 mm in the female with significant differences (p<0.05) between men and women in L1 vertebral Canal sagittal diameter. Sacrum slant angle(unit:o).The ranges of sacrum slant angle were 43.39±8.60°in the male and 37.29±7.36°in the female, demonstrating bigger lumbosacral angle in male than that in women with significant differences (P<0.05).ConclusionThere have obvious morphological and regional differences between male and female in the length of pedicle screw channel, sagittal diameter of pedicle, transverse diameter of pedicle and the sacrum slant angle of lumbar vertebrae, suggesting different criteria for diagnosis of lumbar spinal stenosis and spinal instability should be taken.