Anatomic Parameters for Diagnosing Congenital Lumbar Stenosis Based on Computed Tomography of 1,000 Patients.

Autor:	Shin D; From the Loma Linda University School of Medicine, Loma Linda, CA (Shin, Brandt, Oliinik, Im, Marciniak, Vyhmeister, Razzouk), Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD (Kagabo), Twin Cities Spine Center, Minneapolis, MN (Ramos), Department of Dental Education Services (Oyoyo), Department of Radiology (Wycliffe), Loma Linda University Medical Center, Loma Linda, CA, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (Lipa), Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA (Bono), Division of Orthopaedic Surgery, Jerry L. Pettis Memorial Veterans Hospital, Loma Linda, CA (Cheng), Department of Orthopaedic Surgery, Loma Linda University Medical Center, Loma Linda, CA (Danisa)., Brandt Z, Oliinik M, Im D, Marciniak M, Vyhmeister E, Razzouk J, Kagabo W, Ramos O, Oyoyo U, Wycliffe N, Lipa SA, Bono CM, Cheng W, Danisa O
Jazyk:	angličtina
Zdroj:	The Journal of the American Academy of Orthopaedic Surgeons [J Am Acad Orthop Surg] 2024 Nov 15; Vol. 32 (22), pp. e1186-e1195. Date of Electronic Publication: 2024 Aug 09.
DOI:	10.5435/JAAOS-D-24-00425
Abstrakt:	Introduction: Quantitative parameters for diagnosis of congenital lumbar stenosis (CLS) have yet to be universally accepted. This study establishes parameters for CLS using CT, assessing the influences of patient sex, race, ethnicity, and anthropometric characteristics. Methods: Interpedicular distance (IPD), pedicle length, canal diameter, and canal area were measured using 1,000 patients between 18 and 35 years of age who were without spinal pathology. Results: Irrespective of disk level, threshold values for CLS were 16.1 mm for IPD, 3.9 mm for pedicle length, 11.5 mm for canal diameter, and 142.5 mm 2 for canal area. Notable differences based on patient sex were observed, with men demonstrating larger CLS threshold values with respect to IPD and canal area across all vertebral levels from L1 to L5. Based on patient anthropometric factors, no strong or moderate associations were observed between any spinal measurement and patient height, weight, or body mass index across all levels from L1 to L5. However, notable differences were observed based on patient race and ethnicity from L1 to L5. Asian patients demonstrated the largest pedicle lengths, followed by White, Hispanic, and Black patients in descending order. White patients demonstrated the largest IPD, canal AP diameter, and canal area, followed by Asian, Hispanic, and Black patients in descending order. Black patients demonstrated the smallest values across all anatomic measurements relative to Asian, White, and Hispanic patients. Conclusion: This study reports 25,000 measurements of lumbar central canal dimensions to establish quantitative thresholds for the diagnosis of CLS. Although not influenced by patient height, weight, or body mass index as one might intuit, canal dimensions were influenced by patient sex, race, and ethnicity. These findings may help explain differences in predisposition or prevalence of lumbar nerve root compression among patients of different races, which can be important when considering rates of surgery and access to care. (Copyright © 2024 by the American Academy of Orthopaedic Surgeons.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu