脊柱全长片在腰骶移行椎诊断中的应用

目的：探讨脊柱全长片判定腰骶移行椎的准确性.方法：采用143例脊柱全长影像资料,分析其腰椎骶化（SZ）与骶椎腰化（LZ）分布情况,L5椎体与Tuffier线的关系及矩形化表现.结果：L5椎体在Tuffier线以下者男82.1%,女 79.7%.6例 IIIB型SZ椎体无矩形化表现,7例完全型LZ双侧横突高度小于19 mm.12例T12肋缺如单凭腰椎平片可能误为存在腰骶移行椎（LSTV）.结论：单纯腰椎平片无法避免漏误诊LSTV.只有脊柱全长片才能准确判定LSTV.     

伴腰骶部移行椎的腰椎间盘突出症

本文分析讨论了29例经手术治疗的伴腰骶部移行椎的腰椎间盘突出症。认为该症特点是椎间盘突出发生在L_(5～6)或L_5～移行椎椎间最常见,多数发生在移行椎的上椎间。移行椎的腰骶部神经根走行可有变异,也可不对称;它在解剖上的定位与机能有时不相符合,其感觉和肌力可呈分离现象。临床上往往表现为非单根神经根受损害的症状,在诊断和定位时应充分注意。     

脊柱全长X线片对非矩形化腰椎骶化的诊断价值

目的:探讨脊柱全长X线片对非矩形化腰椎骶化的诊断价值。方法:2008年8月～2009年7月共153例腰腿痛并颈部或胸背部不适的患者接受脊柱全长X线片检查,男84例,女69例,年龄14～82岁,平均47.9±13.7岁。观察其脊柱全长X线片,明确是否有腰椎X线平片难辨出的腰椎骶化。结果:共发现7例腰椎X线平片难辨出的非矩形化完全型腰椎骶化,男5例,女2例,年龄21～60岁,平均39.7±13.7岁。所有骶化的椎体均为正常S1椎体矩形化表现,下方椎间隙为正常S1/2椎间融合表现。合并颈肋2例,第12肋骨缺如4例。结论:脊柱全长X线片能确诊单纯腰椎X线平片难以明确的非矩形化腰椎骶化。     

Oesteogenic Study of Lumbosacral Transitional Vertebra in Central India Region

The morphological variations in the lumbosacral region are accidental findings during the study of dry human sacra. Most easily identified and detectable anatomical variations are related with change in the number of sacral vertebra by union of fifth lumbar vertebra or first coccyx and deletion of first sacral vertebra. These variations may be found in the living during radiological investigations for pain and neurological symptoms of patients.The study was designed to know the prevalence of Lumbosacral Transitional Vertebra in Central India as there is paucity of available literature. Considering the variations, we conduct this study as a prelude to any type of experimental work in biomechanics, for diagnostic and therapeutic purposes in low back pain and for interventional procedures like spinal anesthesia and lumbar puncture.Setting & Design: Observational study was carried out on 206 dry sacra including human skeletons obtained from Department of Anatomy and Forensic Medicine & Regional Medicolegal Institute of Bhopal & Raipur.Morphometric measurements of 168 normal and 38 lumbosacral transitional vertebras were recorded and classified as per Castellvi's classification. Sacra showing fusion of coccyx were also included. All the parameters of variant sacra were compared with normal sacra.38 (18.4%) lumbosacral transitional vertebra of which 29 (14.1 %) cases of sacralization, 9 (4.3%) cases of lumbarization and 16 (7.8%) cases of fusion of coccyx were found. 14(36.8%), 5(13.2%),17(44.7%) and 2(5.3%) sacra falls in type I; type II, type III and type IV of Castellvi's classification.Lumbosacral transitional vertebra is attributed to its embryological origin. These variations is outcome of series of morphological changes during the transition and may interfere with the normal functioning because of compression of nerves, soft tissue and ligamentous strain between joints. Knowledge of these variations have become increasing important because of increased incidence of lower back pain, sciatica, disc prolapsed and in interventional procedures like spinal anesthesia and lumbar puncture.