共查询到20条相似文献,搜索用时 15 毫秒
1.
Lumbar posterior marginal intra-osseous cartilaginous node 总被引:6,自引:0,他引:6
Jean-Denis Laredo M.D. Michel Bard M.D. Jean Chretien M.D. Marcel-Francis Kahn M.D. 《Skeletal radiology》1986,15(3):201-208
This report concerns 12 patients, eight young adults and four adolescents, presenting with lumbar or sciatic pain. This was associated with an unusual defect of the inferior and posterior edges of the vertebral bodies of L4 or L5, together with a small bony ridge protruding into the spinal canal. We found 11 similar cases in the literature all involving adolescents except for one young adult.It has been considered to be the result of a fracture of the posterior ring apophysis in association with a herniated disc. In our cases, in the absence of any known previous trauma, the radiological features and surgical results and the similarity and frequent association with typical lesions of Scheuermann disease, all suggest a posterior marginal cartilaginous node. The inferior lumbar location and frequent association with herniated disc and sciatic nerve root compression in young patients are discussed. 相似文献
2.
Summary This report concerns 35 adult patients with lumbar or sciatic pain and axial CT findings reportedly associated with posterior apophyseal ring fractures. Review of the CT images suggested two pathophysiologic categories. (1) Posterior Schmorl-A posterior intravertebral disc herniation with posterior displacement of a fractured or remodelled vertebral margin. (2) Calcified subligamentous-Reactive annular and or posterior longitudinal ligament calcification at the periphery of a herniated disc with or without remodelling and anterior displacement of the posterior vertebral margin. 相似文献
3.
Sensitivity and specificity of dural sac and herniated disc dimensions in patients with low back-related leg pain 总被引:2,自引:0,他引:2
Narrow spinal canals or herniated discs can be associated with leg pain. However, it is not known whether quantitative measurements of the spinal canal or herniated disc are sensitive and specific for low back-related leg pain. The size and cross-sectional area of the dural sac and any herniated discs were measured from magnetic resonance imaging examinations of 22 asymptomatic individuals and 44 patients with sciatica. The sensitivity and specificity of these measurements were determined. In this small population of patients, a dural sac anteroposterior (AP) diameter of 10.2 mm at the L3-4, L4-5, or L5-S1 vertebral levels was 74% sensitive and 74% specific for leg pain. Based on measurements in symptomatic patients, a herniated disc with an AP diameter of approximately 3 mm was over 95% sensitive and 95% specific. However, if the AP diameters of herniated discs in symptomatic patients were compared with similar measurements in asymptomatic controls, the most sensitive and specific threshold value was 6.8 mm. These findings must be confirmed in a larger population before they are applied clinically. J. Magn. Reson. Imaging 2000;12:439-443. 相似文献
4.
M Jiddane J M Bartoli P Diaz F Nicoli F Grisoli G Salamon 《Journal de radiologie》1985,66(11):679-682
Eleven cases are reported of lateral lumbar herniated disc, an anatomical form presenting fairly atypical features and of relatively recent discovery. The patients presented with a highly painful single root lesion usually affecting L4 and L5 roots. Saccoradiculography was negative in almost all cases whereas computed tomography imaging allowed easy diagnosis of a lateral herniated disc, and demonstrated its foraminal or extraforaminal site. An appropriate surgical approach was thus possible, extremely lateral forms requiring an extraisthmian approach. 相似文献
5.
108例腰椎间盘突出X线诊断分析:X线平片,造影与手术对照 总被引:4,自引:0,他引:4
This article presented the X-ray plain films and myelograms of 108 patients with lumbar disc herniation and comparative study was made with operative findings. The diagnostic accuracy was 92.8%. Hypertrophic changes with lipping at posterior margin of the vertebral body and narrowing of anterior part of disc space with widening of the posterior part were useful signs for localizing the herniated disc. The myelographic signs of pressure on dural sac and nerve roots were evaluated for its significance in localization of the lesion and differential diagnosis. The X-ray manifestations of L S1 herniation were described in detail. 相似文献
6.
Percutaneous automated lumbar nucleotomy 总被引:1,自引:0,他引:1
The results of percutaneous automated lumbar nucleotomy in the treatment of lumbar disc herniation were assessed in a series of 39 patients. The technique consists of mechanical decompression of the herniated intervertebral disc without total excision. Only one-space discs were treated by this method. Sciatica was the predominant clinical symptom in 30 cases, and lumbar pain in 9 cases. Good to very good results were obtained in 70% of patients with sciatica and in 55% of patients with lumbar pain. After 4 cases of nucleotomy performed after failure of nucleolysis were excluded, the proportion of very good results rose to 77% in sciatica. Conversely, it seems that a number of failed nucleotomies can be treated by nucleolysis. Nucleotomy is very well tolerated and deserves to be used as first-line treatment of single and radiologically well documented lumbar disc herniations. 相似文献
7.
P. M. Parizel G. Rodesch D. Balériaux D. Zegers de Beyl J. D'Haens J. Noterman C. Segebarth 《Neuroradiology》1989,31(1):75-79
Summary The Gd-DTPA-enhanced magnetic resonance findings in two patients with herniated thoracic intervertebral discs are reported. The first patient was a 56-year-old woman with a small subligamentous T6-7 disc herniation, slightly lateralized to the right. The second patient was a 51-year-old man with a central and right posterolateral disc herniation, including a large calcified fragment, at the T8-9 level. The nonenhanced MR examination revealed the presence of an extradural mass lesion in both patients, impinging upon the dural sac and compressing and displacing the spinal cord posteriorly. The lesion was slightly hypointense on both T1- and T2-weighted spin echo sequences. Following intravenous injection of Gd-DTPA in a dosage of 0.1 mmol/kg body weight, enhancement of the posterior longitudinal ligament was noted and triangular areas of contrast uptake were seen to occur in the epidural space above and below the herniated disc. At surgery, they were found to correspond to dilated and congested epidural veins. 相似文献
8.
髓核突出类型与腰腿痛严重程度的关系:(附300例分析) 总被引:17,自引:0,他引:17
试验观察了不同类型的髓核突出与患者腰腿痛严重程度的关系。本组300例患者均经手术确诊为腰椎间盘突出症,术前患者疼痛按严重程度分5级。术中观察并记录髓核突出的类型及其与神经根关系,并与术前患者的症状、体征作对照。病变的髓核分以下4种类型:膨出型85例,突出型104例,脱出型72例,游离型39例。结果表明,腰椎间盘突出病人的腰腿痛痛程度与髓核突出的类型有关。椎管内组织的炎症是造成严重腰腿痛的重要因素。 相似文献
9.
CT导引联合注射胶原酶治疗腰椎间盘突出症的技术与临床应用研究 总被引:20,自引:1,他引:20
目的 探讨CT导引下联合注射胶原酶于腰椎间盘突出物表面和突出物内治疗腰椎间盘突出症的技术和疗效。方法 对155例经CT检查证实、临床诊断为腰椎间盘突出症的患者在CT导引下分别于椎间盘突出物表面和突出物内注射胶原酶。L3-4、L4-5采用经椎间孔进针法,L5-S1多采用经小关节内缘、穿黄韧带、达硬膜外进针法。结果 穿刺成功率为100%,经术后3个月至3年的随访,146例疗效优良,优良率为94.2%。随访期间34例进行CT复查,其中32例可见原腰椎间盘突出物变小或消失,疗效均为优、良。2例无变化,疗效为差。2例并发椎间盘炎,经抗炎治疗治愈。结论 CT导引联合注射胶原酶是治疗腰椎间盘突出症安全、有效的方法。 相似文献
10.
Pelvic avulsion injuries occur in both the skeletally immature and adult patient populations. Avulsion injuries are most common in the adolescent age group and usually present as an avulsion of the unfused apophysis at the level of tendon attachment resulting from violent muscular contraction during an athletic endeavor. Acute apophyseal avulsion injuries are usually easily detected and adequately imaged with radiographs, but occasionally advanced imaging such as magnetic resonance imaging or computed tomography is required to detect and fully delineate the extent of injury. Chronic injuries can mimic a more aggressive lesion, but familiarity with the location of various tendon attachment sites on the osseous pelvis can help avoid this pitfall. Traumatic avulsion injuries can also occur in the skeletally mature pelvis; however, in the adult, the presence of a pelvic avulsion fracture in the absence of trauma should be considered a pathological lesion until proven otherwise. This article discusses the clinical and imaging findings of apophyseal avulsion injuries in the adolescent athlete, followed by a discussion of specific pelvis avulsion injuries that occur in the adult population. 相似文献
11.
This prospective study was set up to record the changes in the intervertebral disc accompanying resolution of sciatica following conservative treatment. Patients presenting with sciatica (n = 165) were examined by computed tomography (CT) of the lumbar spine. Disc lesions were classified into the following groups: herniation, sequestration, generalized bulge and focal bulge. Follow-up CT of the pathological disc was performed in 106 of the 165 patients after 1 year and identical anatomical sections were compared. All patients were initially treated conservatively by the injection of steroid and local anaesthetic at the intervertebral disc/nerve root interface. Of 84 cases of disc herniation and sequestration 64 (76%) showed either complete or partial resolution on follow-up CT examination. Of 22 cases with either a generalized or focal bulge of the disc 18 (82%) were unchanged on follow up. The classical disc herniation in a young patient is the type of disc lesion most likely to show greatest improvement at follow-up CT. 相似文献
12.
目的探讨CT导引下多途径经皮激光椎间盘减压术(PLDD)治疗L5~S1椎间盘突出的临床应用。方法在CT导引下对65例L5~S1椎间盘突出患者实施PLDD手术,其中侧后方入路46例;侧方及侧前方入路19例;术后随访所有患者,最长47个月,平均20.3个月。结果总有效率89.2%(58/65),其中显效23例,有效35例,无效6例,椎间盘感染1例。术后3~18个月CT或MR复查44例,其中17例突出的髓核回纳2~4mm,髓核无回纳25例(包括症状明显或较好地改善22例),继发性髓核脱出2例。结论CT导引下多途径PLDD成为治疗L~S椎间盘突出的安全、有效方法。 相似文献
13.
J L Léger R Bouchard R Maltais 《Journal of the Canadian Association of Radiologists》1979,30(2):86-89
Three hundred and five cases of spondylolysis with or without spondylolisthesis were reviewed. The concept of an acquired lesion must be retained even though a dysplastic lesion may be postulated to account for the familial incidence. The examination in erect position facilitates the diagnosis by favoring slipping. The vast majority of lesions are found at L5-S1. Spina bifida occulta is often found in association with spondylolisthesis. This lesion leads to apophyseal arthrosis and disc degeneration at the involved level. The accentuation of the lombosacral angle is not a predominent factor leading to spondylolysis. This angulation will increase with duration and degree of slipping. CT scan provides an excellent account of the state of the spinal canal at the affected level. Could pseudospondylolisthesis be a headed stage of spondylolysis? 相似文献
14.
M Hurme H Alaranta T Aalto L R Knuts H Vanharanta J D Troup 《Acta radiologica (Stockholm, Sweden : 1987)》1989,30(4):353-357
Seven measures at the three lowest lumbar interspaces were recorded from conventional radiographs of the lumbar spines of 160 consecutive patients with low back pain and sciatica admitted for myelography and possible surgery. Eighty-eight patients were operated upon for disc herniation, and of the conservatively-treated 72 patients, 18 had a pathologic and 54 a normal myelogram. The results were evaluated after one year using the occupational handicap scales of WHO. Correlations of radiographic measures to stature were moderate and to age small. After adjusting for stature and age, only the male interpedicular distances and the antero-posterior diameter of intervertebral foramen at L3 were greater than those of females. The males with a pathologic myelogram had smaller posterior disc height at L3 and a smaller interarticular distance at L3 and L4 than those with normal myelogram, likewise the midsagittal diameter at L3 and L4 in females. In all patients other measures besides posterior disc height were smaller than those for low back pain patients (p less than 0.001) or for cadavers (p less than 0.001). The only correlation between measures and clinical manifestations was between pedicular length at L3 and limited straight leg raising. Where the disc material had been extruded into the spinal canal, the interpedicular distance was significantly wider. Only anterior disc height at L3 revealed differences between good and poor outcome one year after surgery, as did the interarticular distance at S1 in patients with normal myelogram after conservative treatment. 相似文献
15.
Nicolas Amoretti Laurent Huwart Pierre-Yves Marcy Pauline Foti Olivier Hauger Pascal Boileau 《Skeletal radiology》2013,42(1):49-53
Objective
To evaluate and compare two groups of patients with sciatica due to intervertebral disc herniation with no neurologic deficit. The groups consisted of patients with intervertebral disc herniation in a medial location (group 1) and those in a lateral location (group 2).Materials and methods
A total of 200 patients were included in the study and were followed for a minimum of 6?months. In our series, we treated 80 postero-lateral herniated discs (40% of cases), 46 postero-medial herniated discs (23%), and 74 foraminal herniated discs (37%). Level L3-L4 was treated in 30 cases (15%), L4-L5 in 98 cases (49%), and L5-S1 in 72 cases (36%). The procedure was performed under dual guidance: fluoroscopic and CT. A helical probe was activated. It penetrates the herniated disc and causes the pulpous material to be mechanically evacuated through the probe. All 200 patients were followed for a minimum of 6?months.Results
In group 1, the patients had a mean pain score of 7.9?±?2.5 VAS units (range 6?C10 units) prior to intervention. This was reduced to 3.2?±?2.1 VAS units (range 0?C10 units) at 48?h follow-up and increased to 3.9?±?1.2 VAS units (range 0?C10 VAS units) at 1?month follow-up and further reduced to 2.7?±?1.2 units (range 0?C10 VAS units) at 6?month follow-up. In group 2, the patients had a mean pain score of 8.2?±?3.2 VAS units (range 6?C10 units) prior to intervention. This was reduced to 2.8?±?1.5 VAS units (range 0?C10 units) at 48?h follow-up and decreased to 1.5?±?0.9 VAS units (range 0?C10 units) at 1?month and further reduced to 1.1?±?0.5 VAS units (range 0?C10 units) at 6?months.Conclusion
Our study showed that results were more satisfactory for the hernia located laterally (postero-lateral, foraminal, and extra-foraminal) as compared to the hernia located posteromedially. 相似文献16.
CT或C臂导引下双点经皮激光椎间盘减压术治疗椎间盘突出症 总被引:1,自引:0,他引:1
目的:评价CT或C臂导引下采用双点(突出椎间盘中后部及患侧1/3处)经皮激光椎间盘减压术(PLDD)治疗椎间盘突出症的临床疗效、优越性及安全性。方法:160例椎间盘突出症患者中颈椎间盘突出12例,腰椎间盘突出148例,单间盘突出者150例,双间盘突(和/或膨)出者10例,所有病例均行双点PLDD术治疗。结果:穿刺成功率97.5%,无严重并发症发生,疗效评价优良率为91.1%。3个月后随访31.9%(51/160)患者突出物不同程度缩小、回纳。结论:双点法能进一步加强PLDD的疗效、操作简便、创伤小、恢复快且CT导引更准确、安全。 相似文献
17.
Summary Herniated nuclear material of the cervical disc often perforates the posterior longitudinal ligament. Of 22 patients who were operated on by an anterior approach, 10 were of this type (the subligamentous type of cervical disc protrusion), while in the remaining 12 patients and 15 discs the protruded disc caused no tear in the ligament (the epiligamentous type). Myelography and CT myelography of these patients were reviewed. On CT myelography a localized and sharply demarcated excavation of the metrizamide ring was commonly found in the subligamentous type. Myelographic lateral view in this group shows a moderate or large indentation of the metrizamide column, since the herniated nucleus pulposus sometimes migrates caudally or cephalically. A small myelographic deformity coupled with diffuse excavation of the metrizamide ring on a CT myelogram leads us to the diagnosis of the epiligamentous type of cervical disc protrusion. In such cases, excision of the ligament is unnecessary during exploration of the discs, except when there is marked depression in the posterior longitudinal ligament. Presurgical recognition of both anatomical processes must be stressed for anterior discectomy. 相似文献
18.
Computed tomography in sciatica 总被引:6,自引:0,他引:6
Lumber facet arthropathy and a herniated disk are two major causes of low back pain and sciatica. The authors evaluated the importance of computed tomography (CT) in 243 patients with low back pain and/or sciatica. Lumbar facet abnormalities were found in 139 patients (57%), and a herniated disk was found in 48 patients (20%). CT findings correlated precisely with surgical observations in cases involving a herniated disk and correlated well with the results of an intra-articular facet block in a small series of patients. CT can effectively diagnose and differentiate between lumbar facet arthropathy and a herniated disk. 相似文献
19.
20.
Kais Maamri Mohamed Amine Hadj Taieb Amine Trifa Ghassen Elkahla Manel Njima Mehdi Darmoul 《Radiology Case Reports》2022,17(5):1760
Clear cell meningiomas (CCM) are a very rare histologic subtype of meningioma usually affecting younger patients. The reported data on spinal CCM are extremely rare. Until today, only 89 cases have been reported. Furthermore, CCM without dural attachment is even rarer since only 19 cases have been reported in English literature. In this article, we present the twentieth case of a spinal CCM without dural attachment. Our patient was a 58-year-old female who was presented with pain in her lower back and bilateral sciatica for 6 months. Magnetic resonance imaging showed an intra-dural well-demarcated lesion at L3. Via a posterior approach, total resection was possible due to the lack of dural adhesion of the tumor. Histologic diagnosis was clear cell meningioma. 相似文献