DR 腰椎生理负重功能位在退行性腰椎不稳检查中的应用  

The application of DR lumbar physiological weight loading function examination in degenerative lumbar segmental instability

作　　者：朱彤[1] 姜毅[1] 王涛[1] 吕蓉[1] 付修威 

机构地区：[1]天津市第三中心医院放射科,天津300170

出　　处：《实用放射学杂志》2016年第5期785-787,795,共4页Journal of Practical Radiology

摘　　要：目的：探讨数字X线摄影术（DR）腰椎生理负重功能位在退行性腰椎不稳检查中的应用价值。方法采用Carestream DRX‐Evolution系统，收集本院临床上诊断L4、L5（80例）和L5、S1（20例）有退行性腰椎不稳疾病的患者共100例，分别进行常规卧位腰椎功能位摄影（对照组）及生理负重腰椎功能位摄影（观察组）。测量2组病变腰椎节段矢状位上的位移或椎间成角情况，并使用统计学软件进行对比分析。结果在100例患者中，卧位及生理负重位显示病变腰椎节段矢状位上位移L4、L5分别为：过屈位卧位（4．50±0．25）mm，负重位（4．78±0．30）mm，过伸位卧位（4．87±0．22）mm，负重位（5．18±0．30）mm ；L5、S1分别为：过屈位卧位（4．64±0．24） mm ，负重位（4．91±0．24） mm ，过伸位卧位（4．95±0．30） mm ，负重位（5．3±0．29） mm ；椎间成角度数L4、L5分别为：过屈位卧位10．64°±0．29°，负重位12．12°±0．57°，过伸位卧位11．57°±0．24°，负重位12．61°±0．28°；L5、S1分别为：过屈位卧位11．63°±0．26°，负重位12．72°±0．27°，过伸位卧位13．55°±0．30°，负重位14．58°±0．33°。2组数据比较差异具有统计学意义（P＜0．05）。结论与传统方法比较，DR腰椎生理负重功能位能更准确地了解腰椎不稳的程度及分级，腰椎阳性检出率提高，为临床诊治方案提供依据。Objective To study the application value of direct digital X‐ray radiography system in the degenerative lumbar insta‐bility .Methods 100 patients with degenerative lumbar instability disease were collected in our hospital ,in which there were L4 ,L5 （80 cases） and L5 ,S1 （20 cases） with degenerative lumbar instability disease .Carestream DRX‐Evolution system was used ,which included conventional horizontal lumbar function photography （control group） and physiological load of lumbar function photography （observation group） .Changes of the displacement or the angle of the lumbar segment on two groups were measured ,and the statisti‐cal software was used to carry on the comparative analysis .Results In 100 patients ,the position and the physiological load position were showed on the sagittal position which were as following ：For the lumbar segment of L4 and L5 ,flexion [position （4 .50 ± 0 .25） mm , load position （4 .78 ± 0 .30） mm] ,extension [position （4 .87 ± 0 .22） mm ,load position （5 .18 ± 0 .30） mm] ,and for the lumbar segment of L5 and S1 ,flexion [position （4 .64 ± 0 .24） mm ,load position （4 .91 ± 0 .24） mm] ,extension [position （4 .95 ± 0 .30） mm , load position （5 .30 ± 0 .29） mm];For the intervertebral angle degree of L4 and L5 ,flexion （position 10 .64° ± 0 .29° ,load position 12 .12°± 0 .57°） ,extension （position 11 .57°± 0 .24° ,load position 12 .61°± 0 .28°）;For the intervertebral angle degree of L5 and S1 , flexion （position 11 .63° ± 0 .26° ,load position 12 .72° ± 0 .27°） ,extension （position 13 .55° ± 0 .30° ,load position 14 .58° ± 0 .33°） , respectively .The difference between two groups was statistically significant （P〈 0 .05） .Conclusion Compared with traditional method ,DR lumbar physiological weight‐bearing functional can more accurately understand the lumbar instability degree ,grading and lumbar positive rate ,which provides the basis for clinical diagnosis and treatment plan

关 键 词：数字X线摄影术 腰椎生理负重功能位 退行性腰椎不稳 

分 类 号：R814.41[医药卫生—影像医学与核医学] R681.5[医药卫生—放射医学]