应用数字骨科技术-研究腰椎失稳节段三维运动特点.doc

天津中医药大学硕士学位论文 ABSTRACT Objective：Application of the combined dual fluoroscopic and CT imaging technique to measure the characteristics of three-dimensional motion of lumbar instability segmental in vivo under physiological weight bearing. Methods：Eight patients with DLIS at L3/4 were studied as instability group(L3/ 4 sections of instability),nine patients with DLIS at L4/5 were studied as instability group(L4/ 5 sections of instability) ,ten healthy Volunteer were recruited as normal group from September 2011 to June 2013 who our department treatment of .Three-dimension (3D) reproduced by matching lumbar spine models of L4,L5 and S1were reconstructed from thin section CT scans . Spine motions were then reproduced by matching lumbar spine models and images got from dual fluoroscopic imaging system (DFIS), The models were matched to the osseous outlines of the images from the two orthogonal views to determine the position of the vertebrae in 3D at each pose. From local coordinate systems at the end plates ,the motion of the cephalad vertebrae relative to the caudal vertebrae was calculated for vertebrae levels . Results: The motions pattern were found to be altered .During flexion-extension, instability of group segments (L3 / 4 ) along the saggittal axis displacement at (3.2 ±2.2) mm, compared with the normal group (2.3 ± 1.7) mm was significantly larger (p 0.05); Instability group segments(L3/ 4) along the vertical axis rotation angle at (4.8 ±4.6) °, compared with the normal group (1.7 ± 1.9) ° was significantly larger (p 0.05). Instability group segments(L3/ 4) along the vertical axis displacement at (0.4±0.2) °, compared with the normal group (1.1±0.8) ° was significantly smaller (p 0.05).During left-right twist ， Instability group segments(L4/ 5) along the vertical axis rotation angle at (4.2±2.0) °, compared with the normal group (2.9±2.7) ° was significantly larger (p 0.05)；During left-right bending,Instability of group (L3/ 4) segments compared with norm