招收飞行学员腰椎峡部裂的X线诊断

目的 探讨招收飞行学员体检中腰椎峡部裂的X线诊断要点.方法 以27例诊断L5双侧峡部裂为研究对象,采用CR或DR机行立位拍摄腰椎正、侧、双斜位X线片,10例加做腰椎X线计算机断层扫描(X ray computed tomography,CT)并二、三维重建.结果 正位片X线征象:①"裂隙征"显示率18.5%(5/27)...

X Ray Diagnosis of Lumbar Spondylolysis in Screening for Aviation Trainees

Objective To investigate the key points in X ray diagnosis of lumbar spondylolysis in screening of aviation trainees.Methods Twenty-seven candidates for aviation students with spondylolysis were studied.The front,lateral and double oblique views of the lumbar spine were acquired in the erect position using CR or DR.Ten subjects underwent computed tomography（CT） examination and two-or three-dimentional reconstruction.Results The posteroanterior X ray radiograph exhibited that ① the visualization rate（vr） of cleft sign was 18.5%（5/27）,② the vr of increased density and bone trabeculae derangement at the lower part of pedicle was 48.1%（13/27）.The lateral X ray radiograph exhibited that ① the vr of laminar isthmus with discontinuity in the upper or lower margin was 85.2%（23/27）,② the vr of decreased density at the lumbar spondylolysis was 85.2%（23/27）,③ 48.1%（13/27） patients had Ⅰ° spondylolisthesis,④ based on the angle between the posterior margin of the lumbar and the superior margin of the spinous process,44.42%（12/27） subjects in the study group and only 1 subject（1/47） in the normal control group exhibited L5 L4.The oblique X ray radiograph exhibited that ① the vr of bilateral or unilateral discontinuity in the upper and lower margin of lumbar was 85.2%（23/27）,② the vr of decreased density at the bilateral or unilateral lumbar spondylolysis was 88.9%（24/27）,③ 21 cases had slender and smaller isthmus compared with L4.CT scan conducted in 10 subjects confirmed the diagnosis of spondylolisthesis.Conclusion The key points in diagnosis of lumbar spondylolysis are：① discontinuity of superior or inferior margins of lumbar laminar isthmus,② decreased density at the lumbar spondylolysis,③ the presence of spondylolisthesis,④ L5L4 according to the angle between the posterior vertebral margin and the superior margin of the spinous process,⑤ cleft sign on the frontal view,⑥ derangement of bone trabicula and increased density at the lower part of the pedicle,⑦ development abnormality with slender and smaller isthmus on the oblique view.① and ② are direct signs,and ③-⑦ are indirect signs.The diagnosis of spondylolysis can be ascertained on either single sign of ① and ② on lateral or oblique views,and bilateral spondylolysis can be ascertained on sign ③ plus ① or ②.