方法:实验研究。
目的:我们试图阐明黄韧带增厚与组织屈曲之间的关联,通过比较MRI图像上和实际组织内的黄韧带厚度,以及与屈曲相关的临床和影像学因素。
背景:黄韧带增厚是腰椎管狭窄的主要原因。组织的屈曲可能会导致黄韧带增厚以及组织肥大;然而,该协会尚未最终建立。
方法:评估了70例腰椎管狭窄患者的黄韧带样品(135例韧带样品)。比较了磁共振成像(MRI)和组织样本中的黄韧带厚度,以评估是否存在屈曲。根据MRI和组织中的厚度之间的差异,将黄韧带样品分为有无屈曲的组。Pearson相关系数检验用于评估MRI和组织中LF厚度之间的关系。MRI组织差异和组织中的LF厚度,和MRI组织差异和MRI上的LF厚度。Further,使用非配对t检验比较屈曲+和屈曲-组之间的差异(MRI上的LF厚度,组织中的LF厚度,年龄,圆盘角度,和光盘高度)和χ2(光盘水平,椎间盘退变,和接受/未接受透析)测试。
结果:MRI和组织中黄韧带厚度呈正线性关系,尽管MRI上的厚度估计明显大于组织本身的厚度。带屈曲的黄韧带在MRI上厚度较大,较少的组织肥大,更严重的椎间盘退变,并且存在于透析率较高的患者中。年龄和椎间盘高度没有差异,angle,或两组之间的水平。
结论:黄韧带屈曲与组织肥大共存,并有助于影像学上感觉到韧带增厚。黄韧带的屈曲倾向于发生在肥大较少的组织中,并且与椎间盘退变的等级以及与脊柱退变相关的其他特征的存在有关。
METHODS: Experimental study.
OBJECTIVE: We sought to elucidate the association between ligamentum flavum thickening and tissue buckling, and the clinical and imaging factors related to buckling by comparing the ligamentum flavum thickness on MRI images and within the actual tissue.
BACKGROUND: Ligamentum flavum thickening is a main contributor to lumbar spinal canal stenosis. Buckling of the tissue may contribute to ligamentum flavum thickening along with tissue hypertrophy; however, this association has not been established conclusively.
METHODS: Ligamentum flavum samples (135 ligament samples) from 70 patients with lumbar spinal canal stenosis were evaluated. The ligamentum flavum thicknesses on magnetic resonance imaging (MRI) and in the tissue samples were compared to assess for the presence of buckling. The ligamentum flavum samples were divided into groups with or without buckling based on the difference between their thicknesses on MRI and in the tissues. The Pearson correlation coefficient test was used to assess the relationships between the LF thicknesses on MRI and in the tissues, MRI-tissue difference and LF thickness in the tissues, and MRI-tissue difference and LF thickness on MRI. Further, differences between the buckling+ and buckling- groups were compared using the unpaired t-test (LF thickness on MRI, LF thickness in the tissues, age, disc angle, and disc height) and χ2 (disc level, disc degeneration, and receival/nonreceival of dialysis) test.
RESULTS: The ligamentum flavum thickness on MRI and in the tissues had a positive linear relationship, although the thickness was estimated to be significantly larger on MRI than in the tissues themselves. The ligamentum flavum with buckling had a larger thickness on MRI, less tissue hypertrophy, more severe disc degeneration, and was present in patients with a higher rate of dialysis. There were no differences in age and disc height, angle, or level between the two groups.
CONCLUSIONS: Buckling of the ligamentum flavum coexists with tissue hypertrophy and contributes to perceived ligamentum thickening on imaging. Buckling of the ligamentum flavum tends to occur in less hypertrophied tissues and is associated with the grade of disc degeneration and the presence of other characteristics associated with spinal degeneration.