警惕脊柱椎间盘退变性疼痛诊断失误及不良后果  

Analysis of the clinical features of 19 patients with pain look-like spinal disc degenerative disease(DDD)

作　　者：姜树军[1] 杨志健[1] 林伟[2] 汪丽芳[1] 刘建民[1] 刘平[1] 李小荟[1] 岳阳[1] 

机构地区：[1]海军总医院干部病房神经内科 [2]海军总医院放射科,北京100048

出　　处：《颈腰痛杂志》2011年第2期100-103,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的通过分析貌似脊柱椎间盘退变性疼痛病例特点,探讨鉴别诊断的经验。方法收集19例貌似脊柱椎间盘退变的疼痛病例,分析其诊断过程和确切病因。结果 19例最初均被诊断为脊柱椎间盘退变,后续进行以脊柱MRI为主的检查,结合肺部CT及腹腔及盆腔超声,明确疼痛病因分别为:脊柱肿瘤,脊柱血管瘤,脊柱结核,胸膜结核,肺癌,主动脉夹层动脉瘤,子宫肌瘤。结论对于与脊柱椎间盘退变性疼痛容易混淆的疼痛疾病,在做脊柱MRI基础上,在胸椎及胸椎以上的疼痛应加做肺部CT检查,在胸椎以下的疼痛应加做腹腔、盆腔超声检查,以免漏诊。Objective To discuss the experiences for differential diagnosis of spinal DDD.Methods To collect 19 patients with pain look-like spinal DDD and to analyze their diagnosing process and the origin of the pain.Results All of the patients were diagnosed as spinal DDD initially.After examined by spinal MRI,with lung CT and abdominal and pelvic ultrasound,the origins of the pain of the patients were found to be spinal neoplasma,vertebral hemangioma,spinal tuberculosis,plural tuberculosis,lung cancer,dissecting aneurysma,uterus myoma.Conclusion For the pain look-like originating from the cervical and the thoracic vertebral level,the spinal MRI and lung CT are helpful to find the origin of the pain.For the pain look-like originating from the lumber and the sacral vertebral level,the spinal MRI and abdominal and pelvic conventional ultrosonography are helpful.

关 键 词：颈肩痛 胸背痛 腰腿痛 椎间盘退变性疾病 脊柱MRI 腹腔、盆腔超声 

分 类 号：R681.55[医药卫生—骨科学]