腰椎手术中的移行椎问题

目的：探讨移位椎的定位方法和移行椎对腰椎手术的影响。方法：回顾性分析了52例腰椎疾患手术治疗的病例，其中腰椎间盘突出症26例，腰椎骨折15例，腰椎滑脱9例，腰椎结核2例，术前均经过X线摄片、CT或MRI检杳。结果：腰部疾患合并移行椎的病例并不少见，本组病例占同期腰椎手术病人的5．3％。腰椎出现移行椎，其定位则石L4—S1，L5—L6，L6—S1。结论：腰部疾患合并移行椎时，腰椎数量发生改变，定位诊断非常重要。要确定手术部位，X线定位片(包括术中X线透视定位)、CT或MRI片缺一不可，但必须注意的是，腰椎CT和MRI检查结果是以骶椎为基准定位，也就是从下往上定位，普通X线片是从上往下序列，两定位诊断的差异，手术时必须高度重视。

The Problem of Transvertebra in Lumbar Operation

Objetive:To discuss the orientation of transvertebra and its affection to lumbar operation.Methods:52 cases with lumbar suffering were retrospected.Among them 26 cases were suffered with intervertebral disc herniation,15 cases with lumbar fracture,9 cases with spondylolisthesis,and 2 cases with lumbar tuberculosis.X ray?CT or MRI examination were taken before operation.Results:It was not few in lumbar disease combined with transvertebral.The rate of this group was 5.3 % to occupy the same term of lumbar operation.The location had L 4S 1?L 5,6 ?L 6S 1 when the lumbar was occurd transvertebra.Conclusion:The location diagnosis was very inportant when lumbar disease combined with transvertebra and lumbar quantity was changed.It was necessary for X ray photo(include X ray located on operation),CT or MRI to decided operative position.It was different for X ray photo located diagnosis to CT or MRI.The different located diagnosis between X ray photo and CT or MRI must be recognized on operation.