Jayakumar Prakash, Nnadi Colin, Saifuddin Asif, Macsweeney Emer, Casey Adrian
Department of Spinal Surgery, The Royal National Orthopaedic Hospital, Middlesex, United Kingdom.
Spine (Phila Pa 1976). 2006 May 1;31(10):E298-301. doi: 10.1097/01.brs.0000216602.98524.07.
Retrospective review of case notes and imaging.
To show the advantage of axial loaded magnetic resonance imaging (MRI) for identification of dynamic degenerative spondylolisthesis as a suspected cause of spinal claudication.
Degenerative spondylolisthesis typically occurs at L4/L5 and is usually evident on plain radiography. However, dynamic degenerative spondylolisthesis may become evident on erect radiographs when not shown on supine radiographs or MRI.
The case notes and imaging (radiography, conventional MRI, and axial loaded MRI) in 2 patients with symptoms of spinal claudication were reviewed.
A 44-year-old female presented with a 3-year history of intermittent low back pain and right leg numbness after a fall. A 52-year-old female presented with a 4-year history of low back pain, bilateral leg weakness, and right leg numbness. In both cases, conventional MRI studies showed mild-to-moderate degenerative disc disease only with no evidence of abnormal spinal alignment or nerve root compression. Axial loaded MRI clearly showed the development of a degenerative spondylolisthesis with central canal stenosis and facet ganglion formation in 1 case.
Axial loaded MRI identified occult dynamic degenerative spondylolisthesis, which correlated with the clinical picture but was not shown on initial conventional MRI or plain radiography.
对病例记录和影像学资料进行回顾性分析。
展示轴向负荷磁共振成像（MRI）在识别动态退行性椎体滑脱作为疑似脊髓间歇性跛行病因方面的优势。
退行性椎体滑脱通常发生于L4/L5水平，在X线平片上通常较为明显。然而，动态退行性椎体滑脱在仰卧位X线片或MRI上未显示时，在站立位X线片上可能会变得明显。
回顾了2例有脊髓间歇性跛行症状患者的病例记录和影像学资料（X线片、传统MRI及轴向负荷MRI）。
一名44岁女性，跌倒后出现间歇性腰痛和右腿麻木3年。一名52岁女性，有腰痛、双侧腿部无力和右腿麻木4年病史。在这两例中，传统MRI检查仅显示轻度至中度椎间盘退变，无脊柱排列异常或神经根受压迹象。轴向负荷MRI在1例中清晰显示了伴有中央管狭窄和关节突神经节形成的退行性椎体滑脱。
轴向负荷MRI识别出了隐匿性动态退行性椎体滑脱，其与临床表现相关，但在最初的传统MRI或X线平片上未显示。
