背景:通过磁共振图像(MRI)分析未命名的层间韧带(ILL)的特征,内镜和病理检查。
方法:回顾性研究分析2021年1月至2022年2月在我们医疗中心接受后路内窥镜手术治疗腰椎间盘突出症或腰椎管狭窄症患者的临床资料。高度,使用T2加权MRI分析韧带的宽度和横截面厚度.同时,还将形态学和病理学特征与黄韧带进行了比较,以强调上述韧带之间的差异。
结果:本研究纳入了43例患者,包括27名男性和16名女性,平均年龄为46.6±12.1.腰椎间盘突出症20例,腰椎管狭窄症23例。宽度,长度,ILL的厚度,腰椎间盘组的LF厚度和手术时间为17.7±3.5mm,4.3±1.3mm,18.3±3.5mm,5.3±1.9mm,53.2±14.5min,分别。在腰椎管狭窄组中,相应参数为16.0±3.1mm,4.1±1.6mm,17.6±4.8mm,6.3±0.8mm,61.8±12.4min,分别。黄韧带厚度的组间差异有统计学意义(P=0.02)。手术时间的差异也得到了证实(P=0.04)。在两个韧带之间的锚点位置和外观方面,确定了内窥镜差异。在活检中也观察到纤维结构的密度和方向的显着差异。在内窥镜下,在疾病谱方面进行比较时,确定了ILL厚度等级的显着差异(P=0.09。)结论:层间韧带是一种尚未正式命名的结构,与黄韧带有显著的结构差异。对于后路内窥镜手术,其临床意义在于其能够作为软组织通道建立的终点。MRI中的黄韧带厚度和内窥镜下的ILL厚度根据疾病谱而变化。
BACKGROUND: To analyze the characteristics of an unnamed interlaminar ligaments(ILL) through magnetic resonance image (MRI), endoscopy and pathological examination.
METHODS: A retrospective study was conducted to analyze the clinical data of patients who underwent posterior endoscopic surgery for lumbar disc herniation or lumbar spinal stenosis from January 2021 to February 2022 at our medical center. The height, width and cross-sectional thickness of the ligament was analyzed using T2 weighted MRI. Meanwhile, the morphological and pathological characteristics were also compared with those of the ligamentum flavum to highlight the differences between above mentioned ligaments.
RESULTS: Forty-three patients were included in this study, including 27 males and 16 females, with an average age of 46.6 ± 12.1y. There were 20 cases of lumbar disc herniation and 23 cases of lumbar spinal stenosis. The width, length, thickness of the ILL, the thickness of LF and surgical time in the lumbar disc group were 17.7 ± 3.5 mm, 4.3 ± 1.3 mm, 18.3 ± 3.5 mm, 5.3 ± 1.9 mm, 53.2 ± 14.5 min, respectively. In the lumbar spinal stenosis group, the corresponding parameters were 16.0 ± 3.1 mm, 4.1 ± 1.6 mm, 17.6 ± 4.8 mm, 6.3 ± 0.8 mm, 61.8 ± 12.4 min, respectively. The intergroup difference in thickness of the ligamentum flavum was statistically significant (P = 0.02). The difference in surgical time was also established(P = 0.04). Endoscopic differences were identified as to the location of the anchor points and appearances among the two ligaments. Significant differences in the density and direction of fibrous structures were also observed under biopsy. Under endoscopy, significant difference as to the grade of ILL thickness was established when compared regarding disease spectrum (P = 0.09.) CONCLUSION: The interlaminar ligament is a structure that has not yet been officially named, which has significant structural differences from those of the ligamentum flavum. For posterior endoscopic procedure, its clinical significance lies in its ability to serve as the endpoint of soft tissue channel establishment. The thickness of the ligamentum flavum in MRI and the thickness of ILL under endoscopy vary according to the disease spectrum.