한국인 하요추부 추간판의 전후 길이에 대한 연구

Abstract

STUDY DESIGN: The anteroposterior dimensions of lower lumbar discs were measured in Koreans and compared with other races.

OBJECTIVES: To obtain the accurate anteroposterior dimension of lower lumbar discs in Koreans and to know if there are any racial differences in lower lumbar disc diameters. To provide safe guidelines during discectomy.

SUMMARY OF LITERATURE REVIEW: Complications of the lumbar discectomy by the posterior approach are rare but lead to the catastrophic event. Especially the major vascular injuries have been reported as having high mortality rates. Anteroposterior disc dimensions are reported for the Occidental, but there has been no report regarding disc dimensions in the Koreans.

MATERIALS AND METHODS: Fifty patients (twenty-five males and females) between 20-50 years old with no significant pathology on the lumbar spine were evaluated using the magnetic resonance images. MPGR (TR=450, TE=15) axial images through the midportion of the L3-4, L4-5 and L5-Sl disc spaces were obtained. Midsagittal, parasagittal, 30' internal and external angled parasagittal lines of each level were measured.

RESULTS: The disc diameters of men were slightly larger than those of women at all levels. The longest mean distance was observed in men at the 30' internal oblique of L3-4 level and the shortest mean measurement was in women at 30' external oblique of L5-Sl level.

CONCLUSIONS: A Statistical difference exists in the midsagittal and male parasagittal disc diameter of lower lumbar discs between the Koreans and the Occidental based on this observation. In both races, during the posterior lumbar discectomy, insertion of instrument less than 30mm in length would be safe except the lateral margins.