腰椎退变性滑脱症的CT诊断

腰椎退变性滑脱症病是引起腰腿痛的原因之一，但介绍其CT表现的国内文献甚少，故我们报告遇见的65例，并对其CT表现作为分析。     

退变性腰椎侧向滑脱的X线诊断（附3例分析）

腰椎退变性滑脱症 (Ｌｕｍｂａｒｄｅｇｅｎｅｒａｔｉｖｅｓｐｏｎｄｙｌｏｌｉｓ ｔｈｅ ｓｉｓ,ＤＳ)是 195 5年由Ｎｏｗｍａｎ发现了脊柱滑脱者多伴有腰椎间盘及腰椎关节突关节的退行性变后而命名的。曹来宾等曾报道 116例ＤＳ ,将这组病例分为前滑脱 (占82 .76 % )和后滑脱 (占 17.2 4% )两型[1] 。查阅手头有关文献亦未发现有两侧滑脱的病例报道。笔者曾收集 3例 ,现就其临床Ｘ线表现作一初步讨论。1　材料与方法本组 3例均为女性 ,农民。年龄分别为 5 1岁、6 8岁及76岁。病程最短者 3个月 ,最长者达 10年余 ,均有突然用力活动史。全…     

腰椎退变性滑脱症的CT诊断及临床意义

目的：探讨腰椎退变性滑脱症的ＣＴ诊断依据和对硬膜囊、神经根的影响。材料和方法：回顾性分析了５８例腰椎退变性滑脱症（前滑脱４６例，后滑脱１２例）的ＣＴ表现、好发部位及其原因。结果：滑椎下缘相邻间盘均显示有相对性前、后膨出，椎小关节均有半脱位，硬膜囊均有受压，另外，在前滑脱中因１６例椎间盘向后上方突出，２３例椎小关节突明显增生肥大而压迫神经根。结论：ＣＴ不仅能诊断腰椎退变性滑脱症，而且还能显示硬膜囊和神经根的改变。     

退变性腰椎滑脱的CT分折

目的 探讨退变性腰椎滑脱的病因和CT诊断价值。方法 回顾性分析了50例退变性腰椎滑脱的CT表现，好发部位及其原因。结果 滑椎下缘相邻间盘均显示有“假性间盘脱出”征，椎间盘及椎小关节退变，椎小关节半脱位，硬膜囊受压。结论 椎间盘及椎小关节退变及韧带的松弛是本病的重要诱因，CT不仅能诊断退变性腰椎滑脱症，还能显示硬膜囊和神经根的改变。     

腰椎退变滑脱的X线与CT表现分析

目的探讨X线平片和CT对腰椎退变性滑脱的诊断价值。方法收集腰椎退变性滑脱92例,对其X线平片和CT进行回顾性分析。结果腰椎退变性滑脱好发于第4腰椎,滑脱程度多在Ⅰ度以内,多合并不同程度的退行性变。X线平片能直观地显示腰椎退变性滑脱,是诊断本病最简单而有效的方法,而CT能清楚显示椎间盘、硬膜囊、关节突和椎管内外结构的变化。结论X线平片与CT结合对腰椎退变性滑脱的诊断和治疗有着重要作用。     

病理性旋转位移评估脊柱手法治疗退变性腰椎滑脱症效果观察

目的:观察脊柱手法治疗退变性腰椎滑脱症(DLS)患椎旋转位移的恢复情况及与临床症状改善的相关性.方法:选择某医院脊柱门诊接诊的DLS患者35例,均接受以坐位定点腰椎旋转复位手法为主的治疗.分别于治疗前及1个疗程后采用日本骨科协会评估治疗(JOA评分)量表评价患者症状改善情况、Logan脊柱X线分析系统测量滑脱椎体异常旋...     

腰椎退变性滑脱症的临床CT分析

目的　探讨L4退变性滑脱症 (L4DS)的临床CT特征及诊断价值。方法　随机抽取了临床资料完整的 47例LDS ,对其中3 6例L4滑脱的临床CT资料进行了全面分析 ,测量了L4下关节突间距 (IAD)和小关节角 (FJA) ,并与对照组比较。结果　L4DS多见于 40岁以上女性 ,主要CT表现为多元性退变、轻度前滑脱和椎管的明显狭窄。滑脱L4的IAD为 17.0 2mm ,FJA为 2 2 .3° ,均小于对照组 (Ρ <0 .0 5 )。结论　CT平扫结合平片和CTM、MPR能显示L4DS的多种征象 ,CT显示为滑脱轻狭窄重 ,小关节发育缩窄可能是L4DS的重要原因     

退变性腰椎后滑脱症的影像学研究(附130例分析)

目的:探讨"退变性腰椎后滑脱影像学诊断。方法:以患者CR片及CT、MR检查,观察和测量病患椎体相对位置变化;并分析有无并发病变。结果:130例本病患者腰椎向后滑脱1.5～11mm,平均3.8mm。所有患者有程度不同的腰椎退变表现。结论:本病皆由腰椎退变而引起,故以"退变性腰椎后滑脱症"命名,它的发生有其解剖学基础,腰椎退变是关键,外力作用为诱因,三者共同作用促成了本病。     

The imaging of lumbar spondylolisthesis

Lumbar spondylolisthesis is a common finding on plain radiographs. The condition has a variety of causes which can be differentiated on the basis of imaging findings. As the treatment is dependent upon the type of spondylolisthesis, it is important for the radiologist to be aware of these features. We present a pictorial review of the imaging features of lumbar spondylolisthesis and explain the differentiating points between different groups of this disorder. The relative merits of the different imaging techniques in assessing lumbar spondylolisthesis are discussed.     

TLIF手术治疗腰椎退行性滑脱

目的总结TLIF手术在腰椎退行性滑脱治疗中应用价值。方法应用TLIF手术治疗腰椎退行性滑脱12例。结果术后随访3-12个月,所有椎间融合器未见移位、松动,内固定无断裂、滑脱等并发症。术后JOA评分22-29分,平均28．2分,满意率91．7％。结论TLIF手术入路在椎管外,椎管内干扰小,避免术后椎管内瘢痕形成,具有固定牢固、卧床时间短、融合率高等优点。     

Radiologic assessment of lumbar intervertebral instability and degenerative spondylolisthesis

Despite many efforts, there is no clear and widely accepted definition of lumbar instability because there are no unquestionable and currently applicable clinical or radiologic criteria available for this entity. This article reviews the current concepts of lumbar instability and the different imaging modalities used to make the diagnosis as evident as possible.     

腰椎小关节退变与椎体滑脱CT征象的相关性分析

腰椎小关节退变又称腰椎小关节综合征,由此导致的椎体滑脱称退行性滑脱即假性滑脱(本文中没有特别注明“真性”二字时,是指假性滑脱),属于临床常见病、多发病,主要危害在于导致椎管狭窄而引发腰腿痛。现代医学影像学及脊柱外科学都偏重于椎弓峡部裂所致的真性滑脱的研究[1-5],而对假性滑脱的讨论相对较少。笔者现收集67例腰椎小关节退变合并32例椎体滑脱的CT平扫图像,着重探讨腰椎小关节形态改变与椎体滑脱CT征象的相关性,以提高真、假性滑脱的鉴别诊断水平,为临床合理治疗提供有力佐证。1资料与方法1·1一般资料本组67例,男26例,女41例;…     

Specific pattern of ruptured annulus fibrosus in lumbar degenerative spondylolisthesis

Summary In order to study the antepriori etiologic factors of degenerative spondylolisthesis, the discograms and CTD were analyzed and the rate of disc slipping and disc indices were evaluated in 30 cases with degenerative spondylolisthesis. (1) The characteristic S-shaped image which extended from anteroinferior to posterosuperior up to the posterior margin of a vertebral body was observed in 89.7% of slipped discs in lateral discograms. CTD revealed that this image represented a circular splitting in the external and intermediate annulus fibrosus. (2) Discographic degeneration of the discs adjacent to a slipped disc was relatively mild, and their disc indices were not significantly different from those of controls. (3) A negative correlation withr = - 0.434 was found between the slipping rate and the disc index. From these results, it was postulated that the site and direction of the circular splitting in laminae of the annulus fibroses, and the direction of the load applied to an intervertebral disc are important etiologic factors of degenerative spondylolisthesis.     

Wiltse手术入路和后正中入路经椎间孔腰椎椎体间融合术治疗退变性腰椎滑脱症

目的 比较后正中入路、Wiltse手术入路经椎间孔腰椎椎体间融合术(transforaminal lumbar interbody fusion,TLIF)治疗退变性腰椎滑脱的临床疗效.方法 2008年3月-2010年3月收治37例退变性腰椎滑脱患者,其中23例行后正中入路TLIF手术(后正中入路组),14例行Wiltse入路TLIF手术(Wiltse入路组),观察两组患者手术前后日本骨科学会(JOA)评分、疼痛视觉模拟评分(visual analogue scale,VAS)及融合情况,比较两组疗效.结果 术后随访6～26个月,平均15.7个月,两组患者腰腿痛等临床症状明显缓解,X线片显示滑脱复位无丢失、植骨融合良好、内固定器械无松动或断裂.术后末次随访时Wiltse入路组融合率为86％,后正中入路组融合率为87％.Wiltse入路组和后正中入路组手术时间分别为(117.8±25.6)min、(128.5±38.7)min(P＞0.05);术中出血量分别为(203.5±16.4)ml、(284.4±27.6)ml(P＜0.05).Wiltse入路组和后正中入路组治疗后JOA评分与治疗前比较均有明显降低(P＜0.05).术后1周腰痛VAS评分两组间比较差异有统计学意义(P＜0.05),腿痛VAS评分两组间比较差异无统计学意义(P＞0.05);末次随访腰痛及腿痛VAS评分两组间比较差异无统计学意义(P＞0.05).结论 后正中入路、Wiltse入路TLIF手术治疗退变性腰椎滑脱均可达到满意的椎间融合率和临床效果,Wiltse入路术中出血量相对较少,术后恢复相对较快.     

Isthmic lumbar spondylolisthesis with sciatica. MR imaging vs myelography

Seventeen patients with sciatica and isthmic lumbar spondylolisthesis were studied with magnetic resonance (MR) imaging. In 13, myelography was also performed: 5 had dural sac deformation and root sleeve shortening, 2 had deformation with unilateral root sleeve shortening, one had bilateral root sleeve shortening only, and one had sac deformation only. In 4, myelography was normal. On sagittal MR examinations the neural foramen had an altered shape bilaterally with the long axis horizontal in all cases. In addition to altered shape the following was found in the 33 foramina evaluated. I: normal nerve (n = 8); II: compressed nerve (n = 16); III: disappearance of fat, nerve not possible to identify (n = 9). In patients with unilateral sciatica, the degree of foraminal stenosis correlated well with the side of symptoms. Coronal views showed the course of the nerve and pedicular kinking. Eight patients underwent decompressive surgery which revealed nerve compression by hypertrophic fibrous tissue and pedicular kinking, which correlated well with the findings on MR. Since the site of nerve compression often was peripheral to the root sleeves, myelography did not give complete information.