Krupski Witold, Majcher Piotr, Tatara Marcin R
II Zakład Radiologii Lekarskiej, Akademia Medyczna im. Prof. Feliksa Skubiszewskiego, Lublin.
Ortop Traumatol Rehabil. 2004 Oct 30;6(5):652-7.
Background. Low back pain is the main reason of reduction in physical activity. The aim of this study was to determine lumbar spine changes in patients with spondylolysis using computed tomography (CT) completed with multiplanar (MPR) and three-dimensional (3D) reconstructions. Material and methods. The investigation was performed on 35 patients at the age from 13 to 79 years suffering from chronic low back pain with recognised lumbar spondylolysis. All these patients were subjected to anteroposterior and lateral radiography, and computed tomography (CT) and CD reconstructions Results. Spondylolysthesis was diagnosed as grade I in thirty patients, grade II in two patients and grade IV in other two patients. No signs of spondylolysthesis observed in three cases. The deformations of intervertebral foramina were confirmed in 26 patients (74.29%) and their craniocaudal narrowing was present in 22 cases (62.86%). The osteophytes around fissure margin of lumbar spondylolysis were found in 20 patients (57.14%). The herniation of nucleus pulposus of intervertebral disc was shown in 11 patients (31.43%). The degenerative changes of L4-L5 and L5-S1 intervertebral joints were present in 9 cases (25.71%), whereas the spina bifida of S1 vertebra was stated in four patients (11.43%). Conclusions. 1. High percentage of deformations and narrowing of the intervertebral foramen and the osteophytes around fissure margin of lumbar spondylolysis, and the intervertebral disc herniation were diagnosed in patients with low back pain and spondylolysis using computed tomography completed with MPR and 3D reconstructions. 2. The axial scans completed with multiplanar and three-dimensional reconstructions are very usefull in diagnostic of spondylolysis and spondylolisthesis.
背景。腰痛是身体活动减少的主要原因。本研究的目的是使用计算机断层扫描(CT)并结合多平面(MPR)和三维(3D)重建来确定椎弓根峡部裂患者的腰椎变化。
材料与方法。对35例年龄在13至79岁、患有慢性腰痛且确诊为腰椎椎弓根峡部裂的患者进行了调查。所有这些患者均接受了前后位和侧位X线摄影、计算机断层扫描(CT)及CT重建。
结果。30例患者被诊断为I度椎体滑脱,2例为II度,另外2例为IV度。3例未观察到椎体滑脱迹象。26例患者(74.29%)证实存在椎间孔变形,22例(62.86%)存在其头尾向狭窄。20例患者(57.14%)发现腰椎椎弓根峡部裂裂隙边缘有骨赘形成。11例患者(31.43%)显示椎间盘髓核突出。9例患者(25.71%)存在L4-L5和L5-S1椎间关节退变,4例患者(11.43%)存在S1椎体脊柱裂。
结论。1. 使用MPR和3D重建的计算机断层扫描在诊断腰痛和椎弓根峡部裂患者时,发现椎间孔变形、狭窄以及椎弓根峡部裂裂隙边缘骨赘形成和椎间盘突出的比例较高。2. 多平面和三维重建的轴向扫描在诊断椎弓根峡部裂和椎体滑脱方面非常有用。