Wood K B, Popp C A, Transfeldt E E, Geissele A E
Twin Cities Scoliosis Spine Center, University of Minnesota, Minneapolis.
Spine (Phila Pa 1976). 1994 Aug 1;19(15):1697-703. doi: 10.1097/00007632-199408000-00008.
The amount of intervertebral motion seen during dynamic radiography when imaged with the patient in the standing position was compared with that obtained with the patient in the lateral decubitus position.
Regarding analysis of spondylolisthesis, whether flexion/extension radiographs should be obtained with the patient in the lateral decubitus or standing position has been anecdotal.
Fifty consecutive adult patients with spondylolisthesis underwent flexion/extension lumbar spine radiographs in both positions. Abnormal motion was considered above 12 degrees dynamic angulation or 8% translation.
Thirty-one of 50 patients displayed abnormal translation. Of these, 18 had abnormal motion only when they were examined in the lateral decubitus position and not when standing. Nine displayed excessive motion in both positions. Only four displayed more translation while standing. There was no statistical difference in the evaluation of dynamic angulation based on patient position. Neither age, degree of slip, listhetic level, nor type of spondylolisthesis correlated with abnormal motion.
When spondylolisthesis is being analyzed, to maximize motion, flexion/extension radiographs should be obtained in the lateral decubitus position.
将患者站立位动态X线摄影时观察到的椎间活动量与侧卧位时获得的椎间活动量进行比较。
关于腰椎滑脱的分析，对于屈伸位X线片检查时患者应采取侧卧位还是站立位，一直存在争议。
连续50例成年腰椎滑脱患者在两种体位下均接受了腰椎屈伸位X线片检查。异常活动被定义为动态成角超过12度或移位超过8%。
50例患者中有31例出现异常移位。其中，18例仅在侧卧位检查时出现异常活动，站立位时未出现。9例在两种体位下均表现为活动过度。只有4例在站立位时移位更多。基于患者体位的动态成角评估无统计学差异。年龄、滑脱程度、滑脱平面及腰椎滑脱类型均与异常活动无关。
分析腰椎滑脱时，为使活动最大化，应在侧卧位下进行屈伸位X线片检查。
