双源CT连续动态扫描评价腰椎不同曲度对椎间孔和椎间盘的影响  

Dual-source CT continuous dynamic scanning for evaluation of influence of different curvature on lumbar intervertebral foramen and intervertebral disc

作　　者：高继平[1] 王增立[2] 李培秀[2] 董巍[2] 徐晓磊[2] 

机构地区：[1]廊坊市人民医院普外科,河北065000 [2]中国石油天然气集团公司中心医院

出　　处：《中国骨与关节损伤杂志》2016年第11期1136-1139,共4页Chinese Journal of Bone and Joint Injury

摘　　要：目的采用双源CT连续动态扫描评价腰椎不同曲度对腰椎间盘突出症患者腰椎间盘突出与椎间孔变化的影响。方法选取自2013-10—2014-10确诊的L4、5椎间盘突出症40例。仰卧位0°的位置为运动过程中动态扫描时的0°位置,根据腰椎矢状面Cobb角测量方法测量运动过程中伸展10°、20°和屈曲10°、20°的图像。测量腰椎间盘突出距离和椎间孔面积。结果在过屈位到过伸位运动过程中,L4、5椎间盘后缘突出程度逐渐增加,从中立位向过屈位运动时L4、5节段椎间盘突出程度变化更加明显。腰椎屈曲运动过程中腰椎每屈曲10°椎间盘突出减少(0.87±0.26)mm;伸展运动过程中腰椎每伸展10°椎间盘突出增加(1.24±0.45)mm。腰椎运动过程中,腰椎每伸展10°其椎间孔面积比仰卧位静态扫描时减小(8.02±0.34)mm^2;腰椎屈曲10°时,90%的患者椎间孔面积比常规仰卧位扫描时减小(6.72±0.23)mm^2;屈曲20°时,82.5%的患者L4、5节段椎间孔面积比静态扫描增时大(7.02±0.15)mm2。结论腰椎双源CT连续动态扫描可以明确诊断常规CT扫描阴性而下肢症状典型和常规CT结果与临床症状差异较大的腰椎间盘突出症患者。Objective To study the changes of lumbar spine in patients with lumbar disc herniation by dual-source CT continuous dynamic scan and observe the prolapse of lumbar intervertebral disc and lumbar intervertebral foramen. Methods Forty cases diagnosed L4,5 lumbar disc herniation from Oct. 2013 to Oct. 2014 were selected. Supine position 0° was the movement in the process of dynamic scanning of 0°. The Cobb angle measurement method was used to determine the dynamic scanning process of extension 10°, 20° and flexion 10°,20°. The lumbar disc herniation distance and intervertebral foramen area were measured. Results L4,5 intertertebral disc prominent degree increased gradually from flexion to extension, the changes of L4,5 segment disc herniation was more pronounced from supine position 0° to flexion. In the process of lumbar flexion motion with lumbar buckling 10°, the intertertebral disc was reduced about （0.87±0.26）mm. While in the process of lumbar extension 10°, the intervertebral disc increased about （1.24±0.45）mm. In the process of lumbar motion, with lumbar extension of 10° the intervertebral foramen area decreased about （8.02±0.34）mm2 than the supine static scan. While in the process of flexion, with lumbar flexion of 10°, 90% patients＇ intervertebral foramen area decreased about （6.72±0.23）mm2 than conventional supine scan. With flexion of 20°, 82.5% patients with L4,5 section intervertebral foramen area was about （7.02±0.15）mm2 bigger than static scan. Conclusion The dual-source CT lumbar continuous dynamic scanning can be applied to patients with negative routine CT scan results but with typical symptom of lower limbs, and patients with big difference between the clinical symptoms and the routine CT scan results.

关 键 词：腰椎间盘突出症 椎间盘 椎间孔 双源CT 动态扫描 

分 类 号：R681.5[医药卫生—骨科学]