中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2010年
5期
358-362
,共5页
脊柱前移%骨疾病,发育性%X线胶片%特征
脊柱前移%骨疾病,髮育性%X線膠片%特徵
척주전이%골질병,발육성%X선효편%특정
Spondylolisthesis%Bone diseases,developmental%X-ray film%Characteristics
目的 对重度发育不良性腰椎滑脱的临床及影像学特点进行初步探讨.方法 回顾性分析2007年3月至2008年12月收治的6例重度发育不良性腰椎滑脱患者(滑脱组,均为女性,年龄为9～12岁)的临床资料,并与因腰痛而就诊的44例儿童(对照组,男性27例,女性17例,年龄9～12岁,影像学检查未见骨折与脱位)进行对比分析,在X线片上测量两组患者骨盆投照角(PI),腰椎前凸角(LL),骶骨后凸角(SK)等指标,比较两组测量值的差异并探讨其临床意义.结果 重度发育不良性腰椎滑脱患者的临床特征是膝关节屈曲、躯干畸形,坐骨神经疼痛;其影像学特征是腰骶关节后凸畸形、骨盆后倾以及拱顶型骶骨;影像学测量方面,滑脱组的LL、PI测量值为(51±10)°、(52±7)°,分别大于对照组的(18±9)°、(43±8)°,差异有统计学意义(P<0.05);滑脱组SK测量值为(12±11)°,小于对照组的(21±10)°,差异有统计学意义(P<0.05).结论 重度发育不良性腰椎滑脱患者外观症状重、神经系统症状轻,腰骶关节连续性中断;PI、LL、SK是其较有意义的影像学测量参数.
目的 對重度髮育不良性腰椎滑脫的臨床及影像學特點進行初步探討.方法 迴顧性分析2007年3月至2008年12月收治的6例重度髮育不良性腰椎滑脫患者(滑脫組,均為女性,年齡為9～12歲)的臨床資料,併與因腰痛而就診的44例兒童(對照組,男性27例,女性17例,年齡9～12歲,影像學檢查未見骨摺與脫位)進行對比分析,在X線片上測量兩組患者骨盆投照角(PI),腰椎前凸角(LL),骶骨後凸角(SK)等指標,比較兩組測量值的差異併探討其臨床意義.結果 重度髮育不良性腰椎滑脫患者的臨床特徵是膝關節屈麯、軀榦畸形,坐骨神經疼痛;其影像學特徵是腰骶關節後凸畸形、骨盆後傾以及拱頂型骶骨;影像學測量方麵,滑脫組的LL、PI測量值為(51±10)°、(52±7)°,分彆大于對照組的(18±9)°、(43±8)°,差異有統計學意義(P<0.05);滑脫組SK測量值為(12±11)°,小于對照組的(21±10)°,差異有統計學意義(P<0.05).結論 重度髮育不良性腰椎滑脫患者外觀癥狀重、神經繫統癥狀輕,腰骶關節連續性中斷;PI、LL、SK是其較有意義的影像學測量參數.
목적 대중도발육불량성요추활탈적림상급영상학특점진행초보탐토.방법 회고성분석2007년3월지2008년12월수치적6례중도발육불량성요추활탈환자(활탈조,균위녀성,년령위9～12세)적림상자료,병여인요통이취진적44례인동(대조조,남성27례,녀성17례,년령9～12세,영상학검사미견골절여탈위)진행대비분석,재X선편상측량량조환자골분투조각(PI),요추전철각(LL),저골후철각(SK)등지표,비교량조측량치적차이병탐토기림상의의.결과 중도발육불량성요추활탈환자적림상특정시슬관절굴곡、구간기형,좌골신경동통;기영상학특정시요저관절후철기형、골분후경이급공정형저골;영상학측량방면,활탈조적LL、PI측량치위(51±10)°、(52±7)°,분별대우대조조적(18±9)°、(43±8)°,차이유통계학의의(P<0.05);활탈조SK측량치위(12±11)°,소우대조조적(21±10)°,차이유통계학의의(P<0.05).결론 중도발육불량성요추활탈환자외관증상중、신경계통증상경,요저관절련속성중단;PI、LL、SK시기교유의의적영상학측량삼수.
Objectives To investigate clinical appearance and radiological characteristics of high grade developmental spondylolisthesis and their significance. Methods In a retrospective study, a group of 6 female patients, who were diagnosed as high grade developmental spondylolisthesis and treated in Peking University third hospital from March 2007 to December 2008 were included. Clinical and radiological characteristics of the 6 patients were investigated and the following parameters were measured on standing lateral X-ray: PI (pelvic incidence), SK (sacral kyphosis) and LL (Lumbar lordosis). A series of 44 patients who came to out-patient department due to LBP and had no positive findings on lateral lumbar X-ray were selected as the control group. The four parameters were compared between study group and control group. Clinical meanings of significant difference were discussed. Results Clinical findings of high grade developmental spondylolisthesis included bending of knees, deformity of trunk and sciatica. Radiological appearances were characterized with kyphosis of lumbo-sacral joint, retroverted pelvis and domed sacrum.Spondylolisthesis patients has an average PI of (52 ± 7) ° which was significant higher than the control group [(43 ±8) °] (P <0. 01 ). LL of study group [(51 ± 10) °] was higher than that of the control group [(18± 9) °] (P < 0. 01) and SK of the study group [(12 ±11)°] were lower than that of the control group [(21 ± 10)°] (P<0.05). Conclusions Characteristics of clinical findings of spondylolisthesis patients have obvious cosmetic appearance, significant pain and lower neurological deficits. Radiological characteristics display deformity of lumbo-sacral joint. PI, LL and SK are significant parameters for high grade spondylolisthesis.
