What Is the Lumbar Spine?

There are five lumbar vertebrae, the vertebral body is tall, the front is high and the back is low, and it is kidney-shaped. The foramen are large and triangular, larger than the thoracic spine and smaller than the cervical spine. The articular process is sagittal, the articular surface of the upper articular process is concave, and the articular surface of the lower articular process is convex, outward and forward. There is a mastoid on the outside of the upper joint, and the spinous process is a square bone plate that projects horizontally backward. The transverse process is short and thin. It extends to the outside and back. There is a small nodule on the back and lower side of the root. It is called the auxiliary process. During the process, the transverse process is the same as the rib. The transverse processes of the 1st to 3rd lumbar vertebrae gradually increase, with the 3rd lumbar vertebra being the longest, and the 4th and 5th lumbar vertebrae becoming shorter. The 5th lumbar vertebra is particularly large and the front of the vertebra is particularly high. When the 5th lumbar vertebra meets the sacrum, it forms a forward protruded promontory.

There are five lumbar vertebrae, the vertebral body is tall, the front is high and the back is low, and it is kidney-shaped. The foramen are large and triangular, larger than the thoracic spine and smaller than the cervical spine. The articular process is sagittal, the articular surface of the upper articular process is concave, and the articular surface of the lower articular process is convex, outward and forward. There is a mastoid on the outside of the upper joint, and the spinous process is a square bone plate that projects horizontally backward. The transverse process is short and thin. It extends to the outside and back. There is a small nodule on the back and lower side of the root. It is called the auxiliary process. During the process, the transverse process is the same as the rib. The transverse processes of the 1st to 3rd lumbar vertebrae gradually increase, with the 3rd lumbar vertebra being the longest, and the 4th and 5th lumbar vertebrae becoming shorter. The 5th lumbar vertebra is particularly large and the front of the vertebra is particularly high. When the 5th lumbar vertebra meets the sacrum, it forms a forward protruded promontory.

Chinese name

Lumbar spine

Department

orthopedics

Lumbar imaging

Vertebral structure characteristics of lumbar vertebral body:

1. The cortical bone scans the cortical bone to form a shell structure surrounding the cancellous bone, with an average thickness of about 1.5 to 3.5 mm. It is divided into three cases according to its thickness and bone characteristics:

a. The anterior edge of the vertebral body and the horseshoe-shaped part on both sides, the shape and the thickness of the cortical bone are relatively regular. The CT value range is 400 500;

b. The pedicle area refers to the side wall of the vertebral body and the posterior wall of the vertebral body. The thickness of the cortical bone in this area gradually increases from the vertebral body toward the pedicle, and it is the thickest at the pedicle. CT value range: 500 800;

c. The interpedicle region is located in the posterior wall of the vertebral body between the pedicles. The thickness of the cortical bone is the thinnest among the three parts, and it is even absent in the middle of the vertebral body, corresponding to the venous sinus of the posterior wall of the vertebral body. CT value range: 200 ~ 400.

2. The cross section scan of cancellous bone compared with cortical bone has a high degree of heterogeneity, and the CT value ranges from several 10 to more than 250. Take the middle part of the vertebrae as an example: the bone in the slightly posterior part of the center of the vertebral body is denser, and the bone in the surrounding part is more scattered, while the near pedicle part is in between, and the cancellous bone in the anterior part of the vertebral body Bone is the lowest; cancellous bone near the upper and lower lumbar endplates is denser on average than the middle of the vertebral body, while the lower part is slightly higher than the upper part.

Lumbar spine related diseases and examinations

Lumbar disc herniation refers to the degenerative lesion of the lumbar disc under external force, the nucleus pulposus tissue protrudes out of the fibrous annulus, causing adjacent spinal nerve roots to be squeezed or compressed to stimulate, causing a series of symptoms. Local pain and limited mobility are the main symptoms of lumbar disc herniation, which lowers the patient's quality of life, gradually develops the disease, and gradually worsens the prognosis.

Lumbar spine pathogenesis

Lumbar disc degeneration, acute injury, chronic injury, aseptic inflammation caused by disc herniation, role of aseptic inflammation in lumbar disc herniation, possible role of immune response in lumbar disc herniation, lumbar disc herniation The formation of mechanical pressure.

Lumbar spine

The most common sites of lumbar disc herniation are L4 to 5 discs, which account for 58% to 62%; L5 to S1, followed by 38% to 44%, and rarely occur in L3 to 4 discs, 2 Intervertebral discs occur at the same time in 5% to 10%. L5 to S1 intervertebral discs are the two lowermost discs in the entire spine. They are the most concentrated parts of the whole body, and they bear the most pressure. The lumbar spine has greater mobility, and the spinal column has the greatest pulling force on the lower intervertebral discs, especially the fibrous rings. Because the sacral spine is fixed and does not participate in spinal movements, the sacral spines do not produce corresponding coordinated buffering movements, and the activities of the upper segments of the spine are finally concentrated on the bottom 2 active segments. Therefore, L4 ~ 5 intervertebral disc injuries are the most likely.

Lumbar imaging

1. There is no special finding in the early lumbar plain film. Lateral spinal stenosis and bone spur formation at the edge of the vertebral body can be seen, or the nucleus pulposus is calcified.

2. CT scans Some hospitals have adopted CT scans as routine preoperative examinations, which have high diagnostic value for spinal canal stenosis, small joint hypertrophy, and lateral crypt stenosis.

3. Three-dimensional imaging can be obtained by MRI, which has great diagnostic value for disc herniation, but it is difficult to popularize because it is expensive.

4. Spinal angiography Since the advent of non-ionic water-soluble contrast agents, spinal angiography has become an effective and safe examination, and many hospitals have listed it as a routine preoperative examination. Its image characteristics are:

(1) The indentation and filling defect are located in the intervertebral space.

(2) The size of the indentation shown in the lateral radiograph is consistent with the size of the lesion, generally> 3mm. In severe cases, it can occupy more than half of the sagittal diameter of the spinal canal.

(3) The filling defect shown by the orthophotos varies depending on the location of the pressure-producing substance, and it is mostly deviated to one side and is consistent with the lesion of the lower extremity pain.

In clinical practice, western medicine treatment methods for lumbar disc herniation are mainly anti-inflammatory and analgesic, and traction therapy, which has a positive effect on alleviating the progress of the disease. Due to the conservative effect of Western medicine on the treatment of lumbar disc herniation, it is difficult to significantly reverse the outcome of the disease, and the disease is likely to relapse. In recent years, the effect of traditional Chinese medicine on the treatment of lumbar disc herniation has been more prominent. With Western medicine treatment, it can further improve the lumbar disc Efficacy of highlight. Prolapse of lumbar intervertebral disc is a frequently-occurring disease in the clinic. There are many common diseases. There are many treatment methods. It is difficult to avoid recurrence. This is determined by the disease itself. As a specialist, the research of this disease is continuously carried out to help patients choose the correct treatment method. Correct exercise rehabilitation guidance and correcting bad habits are the main tasks at present.