摘要
目的研究不同年龄组,不同腰椎滑脱程度与椎弓峡部崩解及腰椎退行性病变的对应关系,探讨不同腰椎滑脱的主要病因,结合临床体征对不同腰椎滑脱患者适当地进行双斜位检查,在减少患者经济负担和电离辐射的同时,准确诊断疾病。方法回顾2002年以来笔者所在医院放射科腰椎滑脱患者316例,对腰椎滑脱采用Meyerding法分级,把腰椎滑脱的患者分为老龄组(腰椎同时有3个以上椎体骨质增生)及青年组(腰椎未见骨质增生或有1～2个椎体骨质增生),同时,在不同年龄组中对不同程度腰椎滑脱患者分组并利用SPSS13.0进行χ2和Fisher精确概率检验分析,得出结论。结果青年组,不同程度腰椎滑脱均与椎弓峡部崩解有明显关联,老龄组,腰椎Ⅰ度滑脱与椎弓峡部崩解并无明显关联,腰椎Ⅱ～Ⅳ度滑脱与椎弓峡部崩解有明显关联。结论在青年组,由于少有腰椎退行性病变,腰椎滑脱多为真性滑脱,由于椎弓峡部崩解所致,提示诊断青年腰痛患者时,对腰椎序列的细微改变要有足够的警惕性,预防漏诊的发生,加照腰椎双斜位是完全必须的,在老年组,腰椎Ⅰ度滑脱与腰椎峡部崩解并无明显关联,有相当多的患者为假性滑脱,考虑到患者经济承受能力及电离辐射,结合患者临床体征,可以定期观察。
Objective To discuss the relationship between spondylolisthesis and spondylolysis as well degenerative change,analyze the necessity of oblique lumbar spine radiography of different spondylolisthesis. Methods 316 cases of spondylolisthesis were included in this study,They were divided into two groups： elderly group （with 3 or more centrums hyperosteogeny） and younger group （with less than 3 centrums hyperosteogeny）, Then they were evaluated according to Meyerding method and analyzed by X2 and Fisher accurate probability examinatlon,Results Among the younger group, any degree of lumbar spondylolisthesis had all prominent relationship with spondylolysis,Among the elderly group,there was no prominent relationship between Ⅰ degree spondylolisthesis and spondylolysis,but Ⅱ-Ⅳ degree spondylolisthesis had prominent relationship with spondylolysis. Conclusion Because of the high false-negative rate of AP and lateral views, oblique views are essential in children and young adults who suffered from any kind of spondylolisthesis.At the same time, there＇s no necessity for all the elders to examine the oblique lumbar spine radiographs when they suffered from Ⅰ spondylolisthesis.
出处
《实用医药杂志》
2007年第6期659-660,共2页
Practical Journal of Medicine & Pharmacy
