动态磁共振成像参数与腰椎不稳的关系

目的:探讨腰椎不稳与脊柱功能单元中的动态磁共振成像参数(椎间盘退变、小关节骨关节炎及黄韧带肥厚)之间关系。方法:按Kong的标准诊断为腰椎不稳患者79例(237个脊柱功能单元),采用动态MRI在患者中立及过屈、过伸3个体位成像。测定L3/L4、L4/L5及L5/S1椎间盘退变(Ⅰ～Ⅴ级)、小关节骨关节炎(1～4级)、黄韧带肥厚(>3mm为黄韧带肥厚阳性)参数,评估其与腰椎不稳的相关性。结果:L4/L5节段不稳(36个)的发生较L3/L4(18个)及L5/S1节段多(25个)。椎间盘退变、小关节骨关节炎以及黄韧带肥厚(+)均与L3/L4、L4/L5、L5/S1 3个节段腰椎不稳相关(P<0.05)。结论:Ⅳ级椎间盘退变、3级小关节骨关节炎及黄韧带肥厚(+)分别与腰椎不稳的形成有关,在诊断腰椎不稳时,动态MRI及其3个参数具有辅助诊断的作用。

Relationship between lumbar instability and radiographic parameters:a kinetic MRI report

Objective:To evaluate the relationship between lumbar instability and parameters in the functional spinal unit including disc degeneration,facet joint osteoarthritis and ligamentum flavum hypertrophy.Method:According to the Kong's criteria,79 cases(a total of 237 functional spinal units)with lumbar instability were subjected to MRI under neutral,flexion and extension position.Segmental range of motion was measured at three levels(L3/L4,L4/L5,L5/S1).Then three radiographic parameters including disc degenerat...