The Morphology of the Lumbosacral Articular Processes in Adult Chinese and Its Biomechanical Implication

Lilt Xin, Yuanyuan Xia, Qingyong Ma
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Abstract

Aim: The morphology of the lumbosacral intervertebral joints in the Chinese race was investigated in the present study to understand the relationship between the articular joint interface and intervertebral disc prolapses. Methods: Spine specimens (N=30) from both male and female adults with ages ranging from 30 to 60 years old were used. They were fixed with 3% formaldehyde, frozen and cut through the intervertebral joints and the intervertebral disc. The angle between the facet joint interface and the median sagittal line on both sides was measured for each joint. Results: The angle between the facet joint interface and the median sagittal line increased gradually from the L1-L2 joint to L5-S1 joint, and the angles in the L4-L5 and L5-S1 joints were both significantly wider than those of other lumbar intervertebral joints. When the angles on the left side were compared with those of the right side, those on the left side were significantly wider than those on the right side. Since the force acting toward the intervertebral disc can be decomposed into one component perpendicular to the facet joint interface and one parallel to the facet joint interface, when the facet joint interface is in a more sagittal position, it blocks less shearing force that acts to slide the vertebra anteriorly. When the facet joint interface is in a more coronal position, it blocks most of the force. Conclusion: Although the L1 –S1 are more coronal in positions on the left side, most disc prolapses happen on the left side, suggesting that some adaptive processes might contribute to the more coronal orientation of these facet joint interfaces or the shearing force act more along the facet joint interface on the other side.
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成人中国人腰骶关节突的形态及其生物力学意义
目的:观察中华民族腰骶椎间关节形态,探讨关节界面与腰椎间盘突出症的关系。方法:选取30 ~ 60岁男性和女性成人脊柱标本30例。它们用3%的甲醛固定,冷冻并切开椎间关节和椎间盘。测量每个关节的小关节界面与两侧正中矢状线之间的夹角。结果:从L1-L2关节到L5-S1关节,关节突关节界面与正中矢状线夹角逐渐增大,且L4-L5和L5-S1关节夹角均明显宽于其他腰椎椎间关节。将左侧的角度与右侧的角度进行比较,左侧的角度明显比右侧的角度宽。由于作用于椎间盘的力可以分解为垂直于小关节界面的一个分量和平行于小关节界面的一个分量,所以当小关节界面处于更矢状的位置时,它阻挡的作用于椎体前滑动的剪切力较小。当小面关节界面处于一个更冠状的位置时,它阻挡了大部分的力。结论:虽然L1 -S1在左侧多呈冠状位,但大多数椎间盘脱垂发生在左侧,提示某些适应性过程可能导致这些小关节界面更呈冠状位,或者剪切力更多地沿另一侧小关节界面作用。
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