Improve The Position Of L5 / S1 Intervertebral Foramen And Iliac Wing Relationship Imaging Studies And Clinical Significance

Objective:By the imaging study of the vertical distance between theL5numb ipsilateral of the inferior articular vertex tothe ipsilateral iliaccrest cross-section on pure contralateral supine andimproved contralateral supine of L5/S1prolapsed vertebral disc patient(see Figure1), the vertical and horizontal diameter of the L5/S1intervertebral foramina, the relation between the Jacoby’s line of Han theHan nationality and their vertebral ganglias, we investigated whether wecan, by improving pure contralateral supine, move down theL5/S1foramen intervertebrale of the wing of ilium or (and) enlarge theforamen intervertebrale of the numb areas, so as to decrease thewithstanding of the wing of ilium or (and) minish the risk of hurting thenerve root when operating the enucleation of the L5/S1nucleus pulposuswith TESSYS Technology through the intervertebral foramina, providinga surgical position easy to overcome the withstanding of wing of iliumand an image morphological basis for the treatment of L5/S1lumberprolapsed vertebral disc with TESSYS Technology through theintervertebral foramina.Methods: from October2009to November2011, there are43casesamong all the130people coming to our hospital for out-patient orin-hospital treatment of L5/S1prolapsed vertebral disc, aging from20to40. Among them,12are male and10are female, with their average agefor32.5, and the disease duration ranged from3months to7years, averaging about3.7years. We operated an MSCT TLCS with the purelycontralateral supine and the improved contralateral supine for the lumbarvertebra, and read films layer by layer on the PACS system, then wecalculated the vertical distance between the L5numb ipsilateral ofthe inferior articular vertex to the ipsilateral iliaccrest cross-section onbetween these two positions. We input the scanning data into the3Dreconstruction software and operated a3D reconstruction of theintervertebral foramina of L5/S1numb areas. Then we measured thevertical and horizontal diameters of the intervertebral foramina ofL5/S1numb areas with the two positions by SSD software. From October2009to November2011, there are130cases of Han people coming to ourhospital for out-patient or in-hospital treatment of the pain on their waistor back with (or without) radiating pain on their lower limbs. Amongthem,79are male and51are female, aging from20to73, with anaverage age of53.3years old. From the X-ray films of the lumbarvertebra and the pelvis, we can observe the Jacoby’s line through relativesection of the vevertebral ganglia.(In this paper, the author dividesvertebral ganglia L4to S1into8section, namely the upper1/3of L4, themiddle1/3of L4, the lower1/3of L4, the gap between L4and L5, theupper1/3of L5, the middle1/3of L5, the lower1/3of L5and the gapbetween L5and S1). statistic analysis:①to test that, by the paired Ttests with standard lateral position, whether there is significantdifferences between the vertical distance between the L5numb ipsilateral of the inferior articular vertex to the ipsilateral iliaccrest cross-section,the vertical and horizontal diameters of the intervertebral foramina ofL5/S1numb areas shown by the CT film when the patient with an L5/S1lumber prolapsed vertebral disc is having CT rays with an improvedlateral position, if P<0.05, the difference is significant).②the ratio ofrelated sections of the Jacoby’s line which pass through the vertebralganglia of grown-ups of Han people in China.Results: compared with the distance measured with a purely contralateralsupine, the vertical distance between the L5numb ipsilateral ofthe inferior articular vertex to the ipsilateral iliaccrest cross-section withan improved lateral position became shorter. The paired T test shows thatP<0.05, namely the value measured with the two positions arecomparatively significant different. The vertical diameters of theintervertebral foramina of L5/S1numb areas with an improved lateralposition is obviously larger than that with an purely contralateral supine,and the paired T test shows that P<0.05, namely the value measured withthe two positions are comparatively significant different. For thehorizontal diameters of the intervertebral foramina of L5/S1numb areaswith these two positions and the results of the paired T test (P>0.05),there are few differences. The ratios of the130patients whose Jacoby’sline passed through the upper1/3, middle1/3, lower1/3of the L4vertebral ganglia and the gap between L4/5are respectively as follows:2.30%（3cases）、5.38%（7cases）、25.38%（33cases）、36.93%（48cases）, and the ratios for patients whose Jacoby’s line passed through the upper1/3, middle1/3, lower1/3of the L5vertebral ganglia and the gapbetween L5and S1are respectively as follows:20.77%（27cases）、6.93%（9cases）、1.54%（2cases）、0.77%（1cases）.Conclusion:1. The improved contralateral supine position can move down theL5/S1foramen intervertebrale of the wing of ilium or (and) enlarge theforamen intervertebrale of the numb areas, so as to decrease thewithstanding of the wing of ilium or (and) minish the risk of hurtingthe nerve root.