退行性腰椎滑脱的CT分析  

CT analysis of lumbar degenerative spondylolysis

作　　者：黄学菁[1] 张闽光[2] 

机构地区：[1]上海中医药大学附属曙光医院放射科 [2]上海中医药大学附属上海市中医医院放射科

出　　处：《中国CT和MRI杂志》2007年第2期40-41,51,共3页Chinese Journal of CT and MRI

摘　　要：目的通过分析CT表现,提高对退变性腰椎滑脱的认识。方法回顾分析了111例(男36例,女75例;年龄31-77岁)的150个滑脱平面的CT表现、滑脱类型、程度及发生部位。对滑脱程度的评价方法进行了研究。结果以下位脊椎为坐标,按上位脊椎的滑脱方向提出了退变性腰椎滑脱分为纵向滑脱和横向滑脱2类。本组病例的滑脱程度均较轻,根据新提出的改良法判断,除11个滑脱平面为Ⅱ度外,其余均为Ⅰ度。腰4-5平面纵向滑脱24例,显著多于腰3-4(6例)和腰5-骶1平面(9例)(χ2=10.08和22.63,P=0.02和<0.001)。横向滑脱主要分布于腰3-4平面(60例)和腰4-5平面(48例),两者之间无显著差异(χ2=0.08,P=0.78),但显著多于腰5-骶1平面的3例(χ2=71.79和65.01,P均<0.001)。结论退变性腰椎横向滑脱与纵向滑脱同样应引起临床重视。改良的滑脱程度判断方法有助于CT检查对各方向滑脱程度的评估。Objective To improve the knowledge of lumbar degenerative spondylolysis by the analysis of CTmanifestafions. Methods CT findings and types, degree andplace of spondylolysis of 150 intervertebral planes with spondylolysis in 111 patients （36 males and 75 females, aged 31-77 years） were retrospectively analysed. Evaluating the means of spondylolysis degree were researched. Results To take inferior vertebra as the relative, degenerative spondylolysis was divided into two types, longitudinal and transverse spondylolysis, according to the spondylolysis direction of superior vertebra. The improved means of evaluating spondylolysis degree was worked out. The spondylolysis degree of 111 patients was low-grade. Based on the improved judgement means, the spondylolysis degree of 11 spondylolysis planes was 11 degree and that of others was I degree. Longitudinal spondylolysis involved lumbar spine in 39 intervertebral planes （L3-4 in six, LA-5 in twenty-four, and L5-S1 in nine）. Transverse spondylolysis involved lumbar spine in 111 intervertebral planes （L3-4 in sixty, L4-5 in forty-eight, and L5-S 1 in three）. Conclusion As the longitudinal spondylolysis, lumbar degenerative transverse spondylolysis should be clinically valued. The improved means of evaluating spondylolysis degree have contributed to the estimation of degree of various directional spondylolysis in CT examination.

关 键 词：腰椎 退行性病变 脊椎滑脱症 体层摄影术 X线计算机 

分 类 号：R681.53[医药卫生—骨科学]