MRI影像测量腰椎黄韧带厚度与退变性椎间盘的关系

背景：腰椎间盘退变和黄韧带增厚都被认为是与老化的变化相关。然而,却很少见用MRI评价黄韧带肥厚自然病程的报道。目的：用MRI评价黄韧带厚度与年龄、椎间隙水平及椎间盘退行性变的关系。方法：MRI测量178例患有腰腿痛的患者的L2/3、L3/4、L4/5、L5S1水平712条黄韧带的厚度。并检验黄韧带厚度与年龄和椎间隙水平及椎间盘退行性变的关系。结果与结论：黄韧带的厚度随着年龄的增加而增加。然而,L4/5、L5S1水平黄韧带厚度的增加要比L2/3、L3/4水平明显。在L4/5水平,在20～29岁年龄段的患者黄韧带厚度已超过3mm。所有的患者如果L2/3水平黄韧带肥厚（〉3.0mm）,那么其余个水平的黄韧带均肥厚。在老年患者中,黄韧带的厚度和椎间盘的退行性变没有相关性。提示在20～29年龄段的患者黄韧带已经开始变厚,而黄韧带的增厚不是随着椎间盘的退变屈曲凸入椎管内的。L2/3水平黄韧带的厚度可以作为一个多水平腰椎管狭窄的指示剂。

The relationship between ligamentum flavum thickening and degenerative intervertebral discs of lumbar spine by MRI image measurement

BACKGROUND：Lumbar disc degeneration and thickening of ligamentum flavum （LF） are considered to be associated with changes in aging.However,the natural course of disease of LF thickening evaluated by MRI is poorly understood.OBJECTIVE：To evaluate the relationships among thickness,age,intervertebral space level and degeneration of intervertebral disc by MRI.METHODS：The thickness of LF was measured at L2/3,L3/4,L4/5 and L5S1 levels （n=712） using MRI in 178 patients with low back pain and/or leg pain.The relationships among thickness,age,intervertebral space level and degeneration of intervertebral disc were detected.RESULTS AND CONCLUSION：The thickness LF increased with age;however,the increments at L4/5 and L5S1 levels were larger than that at L2/3 and L3/4 levels.At L4/5 level,the thickness of LF was over 3.0 mm in patients in the 20-29 age brackets.If all patients with a thickened LF at L2/3 （3.0 mm）,then the remaining levels of LF were thickened.In elderly patients,there was no correlation between the thickness of LF and the degeneration of intervertebral disc.The results show that thickening of LF at L4/5 had already thickened in patients in the 20-29 age bracket.However,the thickening of LF was not the buckling of the LF into the spinal canal with degeneration of intervertebral disc.The thickness of LF at L2/3 can serve as an indicator of lumbar spinal canal stenosis at multiple levels.