Weiss T, Treisch J, Köhler D, Claussen C
Rofo. 1985 Jul;143(1):68-73. doi: 10.1055/s-2008-1052762.
Spinal CT scans of 680 patients with suspected disc herniation were reviewed to detect lumbar spondylolysis. In this group of patients, 3.23% (n = 22) had pars interarticularis defects at L4 or L5. Disc herniation at the interspace of the pars defect was seen in 27.27% (6/22) of patients with spondylolysis. Using Meyerding's method, which measures the degree of vertebral forward dislocation, grade 2 and grade 3 spondylolisthesis were most often seen. While moderate and severe spondylolisthesis can be already detected via lateral localiser image (scout view), pars defects with only little forward dislocation can be easily underdiagnosed. Sources of diagnostic error are: 1. an atypically posterior disc margin which extends beyond only one vertebral body and presents the appearance of disc herniation, 2. pars defects simulating the adjacent facet joints involve the risk of overlooking spondylolysis, 3. CT sections made through the intervertebral discs and facet joints only, may fail to show up the pars defect 10 or 15 mm above the disc plane.
回顾了680例疑似椎间盘突出症患者的脊柱CT扫描，以检测腰椎峡部裂。在这组患者中，3.23%（n = 22）在L4或L5处存在关节突间部缺损。在峡部缺损间隙处出现椎间盘突出的情况在22例峡部裂患者中占27.27%（6/22）。使用测量椎体向前移位程度的迈耶丁方法，最常观察到2级和3级椎体滑脱。虽然中度和重度椎体滑脱可通过侧位定位像（定位视图）检测到，但向前移位较小的关节突间部缺损很容易漏诊。诊断错误的来源包括：1. 非典型的椎间盘后缘超出单个椎体，呈现椎间盘突出的外观；2. 模拟相邻小关节的关节突间部缺损存在漏诊峡部裂的风险；3. 仅通过椎间盘和小关节的CT切片可能无法显示椎间盘平面上方10或15毫米处的关节突间部缺损。
