WANG Yang,WU Han,ZHANG Ziyan.The distance between paraspinal intermuscular cleavage and midline in the lumbar spine and its significance, an MRI study[J].Chinese Journal of Spine and Spinal Cord,2013,(4):316-319.
The distance between paraspinal intermuscular cleavage and midline in the lumbar spine and its significance, an MRI study
Received:April 15, 2012  Revised:January 27, 2013
English Keywords:Multifidus and longissimus muscles  Intermuscular cleavage planes  Paraspinal approach  MRI
Fund:国家自然科学基金资助项目(编号:30772209)
Author NameAffiliation
WANG Yang Orthopadic Department of China-Japan Union Hospital of Jilin University, Changchun,130033, China 
WU Han 吉林大学中日联谊医院骨科 130033 长春市 
ZHANG Ziyan 吉林大学中日联谊医院骨科 130033 长春市 
孙翊夫  
李文选  
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English Abstract:
  【Abstract】 Objectives: To measure the distances between the midline and the intermuscular planes formed by the multifidus and longissimus muscles at each lumbar level(L1-S1) and discuss the distance distribution in Chinese. Methods: Two hundred patients(100 males and 100 females) suffering from low back pain and with lumbar MRI records were selected randomly in our hospital from January 2010 to December 2010. The distance from the convexest point outside the multifidus muscles to the midline at each level between L1 and S1 was measured in MRI scans. The distance distribution at each level was determined by using the statistical methods(such as frequency analysis, t test). The correlation between sex and the measured outcomes was identified. Results: The statistical result showed normal distribution at each level(L1/2, L2/3, L3/4, L4/5, L5/S1). There was no sex-related statistical significance(P>0.05). Overall mean value between the midline and the paraspinal intermuscular planes at disc level from L1/2 to L5/S1 was 16.17±1.87mm, 19.91±2.38mm, 24.97±2.96mm, 29.85±3.45mm, 33.56±3.97mm, respectively. Mean measurement was significantly different between intermuscular cleavage planes and the midline at each lumbar disc level(P<0.05). Conclusions: The distances between the lumbar intermuscular planes and midline in Chinese gradually decrease from L5/S1 to L1/2. No significant correlations exist between males and females. Preoperative measurements in MRI scans provide valuable reference to determine the precise incision in Wiltse′s paraspinal surgical approach.
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