| Objective:To measure the Lumbar 5/Sacral1(L5/S1)foramen segment parameters of normal and Lumbar disc herniation patient by CT imaging,discussing the security of percutaneous endoscopic transforaminal discectomy(PETD) treating Lumbar Disc Herniation(LDH), finding the difference between normal and Lumbar disc herniation patient,to serve accurate anatomical data for the use of PETD.Methods : We selected 163 cases who consult or hospitalized in Department of spine surgery of Affiliated Hospital of Jining Medical College from June 2015 to January 2016.To validate the accuracy of multidetector-row CT data measurement, we measure the AE on the cadaver specimens and compared with the normal group AE to the difference between the two groups.Use the 64 row multi-slice spiral CT(GE Optima CT660) to get lumbar tomography, supine position, scanning conditions for the 120 KV, 300 m AS,scanning the baseline lumbar vertebral 1 to baseline scan for lumbar vertebral margin, with 0.625 mm thick spiral scan and(FOV)25×25.7cm,interval0.625 mm, MPR reconstruction thickness 0.8mm, and the PACS system software in intervertebral foramen entrance plane measurement L5 / S1 intervertebral foramen area, intervertebral foramen height, S1 facet to the highest point of L5 pedicle margin away from the highest point,observe of the intervertebral foramen and recorded data by one person, all data wererecollected after the completion of data aweek later, the average data of two measuring data treat as final measurement results and spss20.0 software was used for statistical analysis.Results: 1.The angle of intervertebral disc endplate:The mean value of the autopsy was 11.280±2.745°, and the average value of the multi-detector CT data was 12.961±3.965°. 2. Intervertebral foramen mean area of L5 / S1 : the left side of the control group were 159.977±23.527mm2, the right side of159.107±23.755mm2; the left group of LDH were 143.391±20.979mm2, the right side of LDH group were143.975±20.478mm2; convex side of degenerate lumbar scoliosis(DLS)176.670±19.826mm2; concave side of DLS were135.778±18.737mm2. 3.L5 / S1 intervertebral foramen mean height :normal left side were 21.787±2.815 mm, the right of 21.921±2.666mm;The left side of the LDH group was 19.075±6.163 mm, the right side was19.890±4.304 mm, and the convex side of DLS group was 23.400±3.452 mm,and the concave side was 20.417±2.619 mm. 4.The highest point of the superior articular process of S1 to the highest point of pediclehe of vertebral arch:The left side of the normal group was 12.902±2.239 mm, the right side was13.176±2.060mm; the left side of the LDH group was 14.252±4.192 mm, the right side was 13.789±3.450mm; scoliosis group of DLS was 14.925±3.245 mm,and the concave side of DLS was 11.332±2.610 mm. 5.The subgect of group intervertebral foramen area, the height of the intervertebral foramen,and the highest point of the S1 on the top of the articular process to the L5 of the loweredge of the highest point of the lower edge between normal group and LDH group was no statistical difference(P > 0.05). There were statistically significant differences in the left and right sides of DLS group(P < 0.05).6.The difference between the normal group and the LDH group was statistically significant(P<0.05).Conclusions:1. There was no significant difference between the corpse measured value and the CT value of people. 2.On both sides of the foraminal area, foraminal height and interval between the upper pedicle and Superior articular process were no significant difference between normal group and LDH group. 3.On both sides of the foraminal area, foraminal height and interval between the upper pedicle and Superior articular process have statistical significance in DLS group. 4. There was significant difference between normal adult and LDH patients with foraminal area, foraminal height and interval between the upper pedicle and Superior articular process. 5.The intervertebral foramen area and height,gender,age,foraminal height was related. 6.PETD should be combined with the height of the intervertebral foramen, height, lateral bending direction and imaging data to further determine the point of view, into the needle point of view and the work channel. |
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