Ligamentum Flavum Hypertrophy in Asymptomatic and Chronic Low Back Pain Subjects

被引:33
|
作者
Munns, Justin J. [1 ]
Lee, Joe Y. B. [1 ]
Orias, Alejandro A. Espinoza [1 ]
Takatori, Ryota [1 ]
Andersson, Gunnar B. J. [1 ]
An, Howard S. [1 ]
Inoue, Nozomu [1 ]
机构
[1] Rush Univ, Med Ctr, Dept Orthoped Surg, Chicago, IL 60612 USA
来源
PLOS ONE | 2015年 / 10卷 / 05期
基金
美国国家卫生研究院;
关键词
SEGMENTAL MOTION; SPINAL STENOSIS; LUMBAR; PATHOMECHANISM; TISSUE;
D O I
10.1371/journal.pone.0128321
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Purpose To examine ligamentum flavum thickness using magnetic resonance (MR) images to evaluate its association with low back pain symptoms, age, gender, lumbar level, and disc characteristics. Materials and Methods Sixty-three individuals were part of this IRB-approved study: twenty-seven with chronic low back pain, and thirty-six as asymptomatic. All patients underwent MR imaging and computed tomography (CT) of the lumbar spine. The MR images at the mid-disc level were captured and enlarged 800% using a bilinear interpolation size conversion algorithm that allowed for enhanced image quality. Ligamentum flavum thickness was assessed using bilateral medial and lateral measurements. Disc height at each level was measured by the least-distance measurement method in three-dimensional models created by CT images taken of the same subject. Analysis of variance and t-tests were carried out to evaluate the relationship between ligamentum flavum thickness and patient variables. Results Ligamentum flavum thickness was found to significantly increase with older age, lower lumbar level, and chronic low back pain (p < 0.03). No difference in ligamentum flavum thickness was observed between right and left sided measurements, or between male and female subjects. Disc height and both ligamentum flavum thickness measurements showed low to moderate correlations that reached significance (p < 0.01). Additionally, a moderate and significant correlation between disc degeneration grade and ligamentum flavum thickness does exist (p < 0.001). Conclusion By measuring ligamentum flavum thickness on MR images at two different sites and comparing degrees of disc degeneration, we found that ligamentum flavum thickness may be closely related to the pathogenesis of pain processes in the spine.
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页数:10
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