Hammouri Qusai M, Haims Andrew H, Simpson Andrew K, Alqaqa Ahmad, Grauer Jonathan N
Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven CT 06520-8071, USA.
Spine (Phila Pa 1976). 2007 Oct 1;32(21):2361-4. doi: 10.1097/BRS.0b013e318155796e.
Retrospective radiographic review.
To assess the utility of lateral dynamic flexion-extension radiographs in the initial evaluation of the degenerative lumbar spine.
Most surgeons obtain standing anteroposterior (AP) and lateral radiographs in the initial evaluation of patients presenting with lumbar complaints. The potential role of dynamic films in this population has not been established.
Of a 390 radiograph series, 342 met inclusion criteria and were reviewed. After assessment of the AP and lateral radiographs, dynamic films were evaluated to determine if additional information was obtained.
Only 2 of the 342 radiographic series had new findings seen on dynamic films not appreciated on the AP and lateral films (a L3-L4 anterolisthesis of 3 mm with flexion and a L5-S1 retrolisthesis of 4 mm with extension). Fifteen additional radiographic series were noted to have a change in the amount of anterolisthesis or retrolisthesis on the dynamic films (changes ranged from 2 to 5 mm).
In the population studied, dynamic radiographs did not significantly alter the initial course of clinical management beyond standing AP and lateral lumbar images.
回顾性影像学检查。
评估腰椎侧位动态屈伸位X线片在退行性腰椎疾病初始评估中的作用。
大多数外科医生在对有腰椎疾病的患者进行初始评估时会拍摄站立位前后位（AP）和侧位X线片。动态X线片在这一人群中的潜在作用尚未明确。
在390例X线片系列中，342例符合纳入标准并接受了评估。在评估AP和侧位X线片后，对动态X线片进行评估以确定是否获得了额外信息。
在342例X线片系列中，只有2例在动态X线片上发现了新的异常，而这些异常在AP和侧位片上未被发现（L3-L4在屈曲时前滑脱3mm，L5-S1在伸展时后滑脱4mm）。另外15例X线片系列在动态X线片上显示前滑脱或后滑脱程度有变化（变化范围为2至5mm）。
在所研究的人群中，除了站立位AP和腰椎侧位片外，动态X线片并未显著改变临床管理的初始流程。
