自控腰椎纵轴加压器诊断隐匿性腰椎退行性变

目的探讨自控腰椎纵轴加压器对隐匿性腰椎退行性变的诊断价值。方法采用自制"自控腰椎纵轴加压器"对120例腰腿痛(98例坐骨神经痛、22例腰痛)患者行腰椎纵轴加压CT/MR检查,所加压力不超过患者体质量的50%,并与常规腰椎CT/MR检查进行比较,硬膜囊面积减小(>15mm2)并降至75mm2以下、侧隐窝狭窄、椎间盘突出或程度增加等异常征像为腰椎纵轴加压检查的附加有效信息(AVI)。结果 120例中43例存在AVI,包括硬膜囊面积减小33例,椎间盘突出11例和突出程度增加15例,侧隐窝或椎间孔狭窄12例。98例坐骨神经痛患者中40例(40/98,40.82%)出现AVI,22例腰痛患者中仅3例(3/22,13.64%)出现AVI(P<0.05)。结论腰椎纵轴加压CT/MR检查对显示腰椎及椎管的隐匿性退行性变具有重要临床价值。

Self controlled axial loading device of the lumbar spine in diagnosis of concealed degeneration of lumbar spine

Objective To explore the diagnostic value of hiding degenerative changes of lumbar spine with with self-controlled axial loading device of the lumbar spine. Methods Totally 120 patients were examined by paired posas relaxed position CT/MR (PRP CT/MR) and axial compression in extension CT/MR (ACE CT/MR) with self-controlled axial loading device of the lumbar spine controlled, with compression less than 50% of the patient's weight. The results were compared with conventional CR/MR. Decrease of dural sac cross sectional area (>15 mm²) to values smaller than 75 mm², narrow lateral recess, narrow intervertebral foramen, lumbar disk heriation were considered as additional valuable information(AVI). Results AVI was found in 43 of 120 patients, including decrease of dural sac cross sectional area in 33 patients, narrow lateral recess and (or) narrow intervertebral foramen in 12, lumbar disk heriation in 11 and to a greater extent in 15 patients. AVI was found in 40 of 98 (40/98, 40.82%) patients with sciatica and 3 of 22 (3/22, 13.64%) patients with low back pain (P<0.05). Conclusion ACE CT/MRI with self-controlled axial loading device has important value of clinical evaluation on hiding degenerative changes of lumbar spine.