670例腰椎小关节退行性变的多层螺旋CT诊断与临床对比分析

目的：探讨腰椎小关节退行性变的多层螺旋CT表现及在临床腰腿痛中的评价.方法：回顾性分析我科2012年6月至2013年9月接诊的670例腰腿痛患者,均行L3/4,L4/5,L5/S1椎间盘多层螺旋CT扫描,软窗和骨窗分别显示.结果：腰椎小关节骨质增生肥大,骨赘形成,多出现于关节突的外侧缘;腰椎小关节间隙以变窄多见;腰椎小关节面毛糙、硬化、凹凸不平及关节骨皮质下囊变;腰椎小关节半脱位;腰椎小关节腔内积气.腰椎小关节退行性变随年龄段增大MSCT阳性率越高,670例腰椎小关节退行性变中20岁-70岁年龄段经统计学卡方检验,CT检查阳性病例数与阴性病例数两组有显著性差异,具有统计学意义（P＜0.01）.伴随征象：腰椎体骨质增生,椎间盘膨出、突出,椎间盘“真空征”,黄韧带肥厚、钙化等.结论：多层螺旋CT腰椎间盘轴位扫描骨窗可清晰显示腰椎小关节的解剖结构及其退行性变的病理改变,更有利于显示细微的骨质改变（如骨皮质下囊变）,为腰椎小关节退行性变的诊断提供充分可靠的影像学依据,从而提高诊断率,明确腰椎小关节退行性变在获得性椎管狭窄引起的腰腿痛发展过程中的作用.

Analysis of 670 cases of lumbar facet joint degeneration of spiral CT diagnosis and clinical comparison

Objective：To investigate the spiral CT manifestations of lumbar facet joint degeneration and clinical pain in. nethods：A retrospective analysis of 670 cases of low back pain patients in our department from 2012 June to 2013 September were, were examined by L3/4, IA/5, LS/S1 disc muhislice spiral CT scan, the soft and bone windows are displayed. Results：The lumbar facet joint bone hyperplasia and hypertrophy, osteophyte formation, lateral margin appears in the articular process of lumbar facet joint space narrowing; to see; cystic degeneration of lumbar facet joint rough, uneven hardening, cortical bone and joint; subluxation of lumbar facet joint; lumbar small joint cavity pneumatosis. Degeneratie lumbar joints increases with age, the higher the rate of positive of MSCT, 670 cases of lumbar vertebra small joint degeneration of 20-70 age group by statistical chi-square, CT examination positive cases with negative cases in the two groups have significant difference, statistically significant （P〈O.01）.Accompanied signs： lumbar hyperosteogeny, disc bulging, prominent, intervertebral disc ＂vacuum＂ sign, yellow ligament hypertrophy, calcification. Conclusion： Multi slice spiral CT in lumbar disc axial scan bone window can clearly show the anatomy of the lumbar facet joint pathological changes of structure and degeneration, more conducive to reveal the change of fine bone （such as cortical bone cyst）, provide reliable imaging information for the diagnosis of lumbar facet joint degeneration, and to improve the accuracy of diagnosis, clear the degenerative lumbar facet joints during the development of low back pain for spinal stenosis caused by the effect of.