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Evaluations of computed tomography images and lumbar specimens in mimic operations of transverse rotation laminoplasty for lumbar spinal stenosis.

Pei XW, Liang YH, Zhang H, Gong ZS, Song HX - Chin. Med. J. (2015)

Bottom Line: The total length of the spinous process plus one side laminae after the operation was evaluated and compared with the length of inner margin of pedical before the operation.In the human lumbar vertebrae specimen, the data similar to the former.The TRL provided a new alternative in the treatment of LSS.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.

ABSTRACT

Background: Laminectomy is a major method to treat lumbar spinal stenosis (LSS), but it has lots of flaws such as scar tissue can form around the dura again or spinal instability. This study aimed to investigate the feasibility of transverse rotation laminoplasty (TRL) in the treatment of LSS.

Methods: The mimic operations of TRL were performed both in the computerized image processing and on the lumbar specimen. Computed tomography (CT) images were either collected from 80 clinical patients with complaints of lumbago or obtained from 40 sets of lumbar specimens after rebuild of spinal canals. In the CT image processing the heights of the spinous process and laminae at L3-L5 were measured. The total length of the spinous process plus one side laminae after the operation was evaluated and compared with the length of inner margin of pedical before the operation. The areas of the vertebral canal were examined before and after the operation.

Results: In the CT images, the height of spinous process of L3, L4 and L5 was 24.74 ± 3.45, 22.68 ± 5.96 and 21.54 ± 4.12 mm respectively, and that of laminae was 23.66 ± 2.32, 22.68 ± 5.36 and 20.99 ± 3.67 mm respectively (P > 0.05). Distance of inner border of pedical of L3, L4 and L5 was 23.01 ± 6.59, 24.65 ± 5.54 and 26.03 ± 7.34 mm respectively, and length of spinous process with laminae of those was 29.76 ± 4.91, 29.31 ± 6.43 and 32.53 ± 5.76 mm respectively (P < 0.05). Preoperative area of spinal canals of L3, L4 and L5 was 299.81 ± 10.09, 297.66 ± 9.54 and 308.22 ± 10.04 mm2 respectively, and postoperative area was 480.01 ± 9.33, 487.32 ± 8.65 and 501.03 ± 9.12 mm2 respectively (P < 0.05). In the human lumbar vertebrae specimen, the data similar to the former.

Conclusions: The excised canal posterior was covered, and the lumbar canals enlarged by TRL. The TRL provided a new alternative in the treatment of LSS.

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Related in: MedlinePlus

Preoperative spinous process and laminae.
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Figure 1: Preoperative spinous process and laminae.

Mentions: The height of the spinous process and laminae were evaluated on the three-dimensional images directly at the CT. And then the CT images were read into the computer. With the help of image analysis software Photoshop CS5 (Adobe Inc. USA), the lamina was dissected at the medial border of pedicle. The spinous process and laminae were rotated 100° clockwise or counter-clockwise. The spinous process plus one side of laminae were put on the decompressed vertebral canal posterior wall as shown in Figures 1 and 2. And then a cursor was used to trace the landmarks and borders on the CT images at L3-L5 for the Photoshop software could be used to calculate the preoperative distance of inner border of pedical and the area of lumbar canal on the cross section were determined, and the postoperative length of the spinous process plus one side of the laminae and the area of vertebral canal were measured as well. These data was compared each other. Due to hand-made landmarks, so the values are not accuracy absolutely, but reliability is high because the same one works.


Evaluations of computed tomography images and lumbar specimens in mimic operations of transverse rotation laminoplasty for lumbar spinal stenosis.

Pei XW, Liang YH, Zhang H, Gong ZS, Song HX - Chin. Med. J. (2015)

Preoperative spinous process and laminae.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4837837&req=5

Figure 1: Preoperative spinous process and laminae.
Mentions: The height of the spinous process and laminae were evaluated on the three-dimensional images directly at the CT. And then the CT images were read into the computer. With the help of image analysis software Photoshop CS5 (Adobe Inc. USA), the lamina was dissected at the medial border of pedicle. The spinous process and laminae were rotated 100° clockwise or counter-clockwise. The spinous process plus one side of laminae were put on the decompressed vertebral canal posterior wall as shown in Figures 1 and 2. And then a cursor was used to trace the landmarks and borders on the CT images at L3-L5 for the Photoshop software could be used to calculate the preoperative distance of inner border of pedical and the area of lumbar canal on the cross section were determined, and the postoperative length of the spinous process plus one side of the laminae and the area of vertebral canal were measured as well. These data was compared each other. Due to hand-made landmarks, so the values are not accuracy absolutely, but reliability is high because the same one works.

Bottom Line: The total length of the spinous process plus one side laminae after the operation was evaluated and compared with the length of inner margin of pedical before the operation.In the human lumbar vertebrae specimen, the data similar to the former.The TRL provided a new alternative in the treatment of LSS.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.

ABSTRACT

Background: Laminectomy is a major method to treat lumbar spinal stenosis (LSS), but it has lots of flaws such as scar tissue can form around the dura again or spinal instability. This study aimed to investigate the feasibility of transverse rotation laminoplasty (TRL) in the treatment of LSS.

Methods: The mimic operations of TRL were performed both in the computerized image processing and on the lumbar specimen. Computed tomography (CT) images were either collected from 80 clinical patients with complaints of lumbago or obtained from 40 sets of lumbar specimens after rebuild of spinal canals. In the CT image processing the heights of the spinous process and laminae at L3-L5 were measured. The total length of the spinous process plus one side laminae after the operation was evaluated and compared with the length of inner margin of pedical before the operation. The areas of the vertebral canal were examined before and after the operation.

Results: In the CT images, the height of spinous process of L3, L4 and L5 was 24.74 ± 3.45, 22.68 ± 5.96 and 21.54 ± 4.12 mm respectively, and that of laminae was 23.66 ± 2.32, 22.68 ± 5.36 and 20.99 ± 3.67 mm respectively (P > 0.05). Distance of inner border of pedical of L3, L4 and L5 was 23.01 ± 6.59, 24.65 ± 5.54 and 26.03 ± 7.34 mm respectively, and length of spinous process with laminae of those was 29.76 ± 4.91, 29.31 ± 6.43 and 32.53 ± 5.76 mm respectively (P < 0.05). Preoperative area of spinal canals of L3, L4 and L5 was 299.81 ± 10.09, 297.66 ± 9.54 and 308.22 ± 10.04 mm2 respectively, and postoperative area was 480.01 ± 9.33, 487.32 ± 8.65 and 501.03 ± 9.12 mm2 respectively (P < 0.05). In the human lumbar vertebrae specimen, the data similar to the former.

Conclusions: The excised canal posterior was covered, and the lumbar canals enlarged by TRL. The TRL provided a new alternative in the treatment of LSS.

Show MeSH
Related in: MedlinePlus