Lumbar Spine Disease 환자의 2D Sagittal Reformation 시 Reformation Angle에 따른 Intervertebral Foramina Image에 대한 고찰

Consideration to Intervertebral Foramina Images with Change of Reformation Angle at 2D Sagittal Reformation in Lumbar Spine Disease

Purpose Intervertebral foramina disc disease and it’s degeneration cause myelopathy or radiculopathy with lumbar back pain. These makes stenosis or obstruction of nerve root pad1way. It is in1portant structure for the decompression during minimal invasive surgery or surgical operation. We used to two dimensional(2D) sagittal reformation of multi-detector computed tomography(MDCT) helical scan in foraminal stenosis or foraminal disc cases. At this time, We obtain derail informations of intervertebral foramina(IVF) with spine disease and study IVF images by reformation angle. Materials and methods We studied lumbar spine CT(men: 20 cases, average age: 33.8 years) with helical scan using Philips Brilliance 16 channel MDCT, from Jun 2009 to Aug 2009. We examined helical scan and performed 2D sagittal reformation. At this time, We established six reformation angle techniques; midsagittal plane(MSP), L4 pedicle, L4-5 facet, L5 pedicle, L5-S1 facet, S1 pedicle. And we established L4-5, L5-S1 IVF and tested both them with comparison. Image analysis was measured three portions of IVF. We measured superior inferior dimension; length of straight line from upper margin to lower margin in IVF, superior anterior posterior; length of distance in straight line at facet joint level and inferior anterior posterior; length of distance in straight line at posterior body margin. Results As results, 2D sagittal reformation with six reformation angle techniques, case of parallel L5-S1 facer was measured right 41.6, left 42.9° mostly and case of parallel L4 pedicle was measured right 12.2, left 13.7° to bottom. As results, measuring three portions of IVF, in L4-5 IVF, case of parallel L4-5 facet was measured increasing superior to inferior dimension measurement(SID; right 21.86, left 21.61 mm) and case of parallel L5-S1 facet was measured increasing SID(right 22.34, left 22.26 mm) with comparison of parallel midsagittal plane. As results, measuring three portions of IVF, in L5-S1 IVF, case of parallel L4-5 facet was measured increasing SID(right 21.71, left 20.67 mm) and case of parallel L5-S1 facet was measured increasing SID(right 21.66, left 21.00 mm) with comparison of parallel midsagittal plane. Superior anterior-posterior measurement(SAP), inferior anterior-posterior measurement(IAP) of IVF in L4-5, L5-S1 are unremarkable. Conclusion Cases of parallel facet joint are checked increasing SID with comparison other conditions. So we established useful reformation angle techniques that these increased diameter of upper-lower structure of IVF and expanded space of passing nerve root.