青少年腰椎峡部裂的影像学特征及新疗法

目的探讨青少年腰椎峡部裂的影像学特征及新疗法,提高对该病的诊断能力并为该病的治疗提供新思路。 方法回顾性分析1例接受C臂机引导下于L₅峡部裂断端处注射金葡素治疗L₅峡部裂患者的影像学特征及疾病转归。 结果患者X线片表现为L₅椎间孔后上壁不连续,出现明显裂隙,形成典型"项圈征";CT扫描表现为L₅双侧峡部骨质不连续,呈裂隙状,其边缘增生硬化凹凸不平呈锯齿状改变,形成典型"裂隙征"与"碎裂征";L₅双侧峡部裂诊断明确,采用C臂机引导下于L₅峡部裂断端处注射金葡素治疗。随访12个月,患者症状、体征较术前改善显著且断端获得骨性愈合。 结论腰椎峡部裂的诊断主要依赖于影像学检查,因此深入了解其影像学特征、掌握诊断要点,对准确诊断腰椎峡部裂尤为重要;另外,C臂机引导下于腰椎峡部裂断端处注射金葡素疗法独到新颖、疗效确切、安全微创、经济方便,值得推广应用。

Imaging characteristics and new therapy of adolescent lumbar spondylolysis

ObjectiveTo explore the imaging characteristics and new therapy of adolescent lumbar spondylolysis, in order to improve the diagnostic ability and provide the new ideas for the treatment of the disease. MethodsRetrospective study of one patient with L₅ bilateral spondylolysis who had underwent the treatment of staphylococcal enterotoxin c injection guided by C-arm X-ray. ResultsX-ray presented discontinuity of L₅ pedicle isthmus where appeared a visible crack that forming a typical "scotty dog sign" . CT scan presented disunion of L₅ bilateral pedicle isthmus, the hyperplasia and sclerosis of the broken edge made it uneven and serrated shaped that forming a typical "crack sign" and "fracture sign" . The diagnosis of L₅ bilateral spondylolysis was clear and the patient′s clinical signs and symptoms were significantly better than the condition before the treatment and bony union was in 1 year after the therapy of staphylococcal enterotoxin c injection guided by C-arm X-ray. ConclusionsThe diagnosis of lumbar spondylolysis is mainly depended on imaging examination, thus giving insight into the imaging characteristics and grasping the key points of diagnosis of lumbar spondylolysis are particularly important to make the accurate diagnosis.Moreover, the treatment is worthy of being clinically spread for its novelty, economy, convenience, security and minimal invasion.