腰椎滑脱120例X线及CT表现分析
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【摘要】目的：分析腰椎滑脱的X线及CT表现，并比较X线和CT对该疾病的诊断价值，以提高对该疾病的诊断水平。方法：回顾性分析腰椎滑脱病例120例，均摄X线腰椎正侧位片，26例摄双斜位，34例摄过伸过屈侧位，44例行ct扫描。结果：真性滑脱23例，X线确诊21例，正侧位11例显示峡部裂；17例摄双斜位，15例显示峡部裂；16例摄过伸过屈侧位片，11例显示滑脱椎体移位程度变化；CT扫描18例，确诊18例。假性滑脱97例，13例摄过伸过屈侧位片，滑脱椎体移位程度无明显变化；CT扫描26例，确诊24例，均显示不同程度的椎管形态改变、椎间小关节退变、椎间盘退变及软组织改变。结论：X线平片可以基本满足腰椎滑脱的诊断需要，过伸过屈侧位片可发现轻微滑脱，CT扫描对真假性滑脱鉴别、椎管形态改变、椎间盘退变、椎间小关节退变及软组织状况的显示更为确切。
【关键词】腰椎滑脱； X线平片；CT扫描
Radiological analysis of X-ray and CT characterization of 120 cases of lumber spondylolisthesis
【Abstract】 Objective To analyze the X-ray and CT findings of lumber spondylolisthesis, then compare the diagnosis of lumbar spondylolisthesis value between X-ray and CT, in order to improve the diagnostic level. Methods 120 cases of lumber spondylolisthesis were retrospectively analyzed. All of the cases were on anterior-posterior and lateral view of X-ray plain film. In which 26 cases with double oblique position film, 34 cases with over-flexure and over-extending posture film, 44 cases with CT scan. Results There were 23 cases of true spondylolisthesis, 21 cases were diagnosed through ordinary X-ray plain film, side position piece in 11 patients showed spondylolysis. 17 cases with double oblique position perturbation,in which 15 cases showed spondylolysis. 16 cases with over-flexure and over-extending posture film,11 cases showed spondylolisthesis shift changes. 18 cases with CT scan, all the cases were confirmed of spondylolisthesis. However, 97 cases of false spondylolisthesis, no obvious slippage in 13 cases of over-flexure and over-extending posture film. 26 cases with CT scan, diagnosed in 24 patients, showed varying degrees of spinal canal morphology, intervertebral facet joint degeneration, intervertebral disc degeneration and soft tissue change. Conclusion Diagnosis of spondylolisthesis, ordinary X-ray plain film can basically meet the need，over-flexure and over-extending posture film can find slight spondylolisthesis. But CT scan can distinguish ture spondylolisthesis from false ones. And CT scan can display exactly about spinal canal morphology, intervertebral disc degeneration, facet joint degeneration and soft tissue condition.
【Key Words】：Lumber spondylolisthesis； X-ray plain film；Computed tomography scan
腰椎滑脱分真性滑脱和假性滑脱两大类，由于椎弓峡部裂或不连引起的椎体向前/后滑动称为真性滑脱；由于椎小关节病变或椎间盘病变引起的椎体向前/后滑动、而无峡部断裂缺损者称为假性滑脱,又称为退变性腰椎滑脱。
本文收集120例腰椎滑脱患者的X线及CT资料加以分析，现汇报如下：
1.资料与方法
1．1 一般资料
选取我院2010年4月～2011年6月确诊的腰椎滑脱患者120例，男41例女79例，年龄17～90岁，平均 57.4岁。所有病例均摄X光腰椎正侧位片，26例摄双斜位，34例摄过伸过屈侧位；44例行CT扫描。