模拟负重前后腰椎间盘变化的CT测量及其意义

The value of CT measurements of lumbar intervertebral disk before and after immitate loading

目的:探讨负重前后腰椎及其间盘的变化及其临床意义。方法:对连续68例腰腿痛病人分别在模拟负重前、后扫描L3～4、L4～5、L5～S1间隙,对加压前、后各间盘矢径、冠径、斜径及L1下缘至S1上缘的前径和后径进行测量,观察各径线的变化。结果:加压后L3～4间盘矢径、冠径、斜径增加≥1mm者分别是31例、29例和34例,L4～5间盘矢径、冠径、斜径增加≥1mm者分别是48例、32例和34例,L5～S1间盘矢径、冠径、斜径增加≥1mm者分别是39例、33例和38例;加压后腰椎前径缩短≤-1mm46例,后径缩短≤-1mm38例。P值均<0.01,模拟负重后腰椎间盘各径增加具有显著统计学意义。结论:模拟负重后腰椎间盘扫描有利于发现轻微的椎间盘膨出和突出,并指导临床治疗。

Objective: To investigate the change of lumbar intervertebral disk before and after immitate loading detected by CT measurements and evaluate its clinical significance. Materials and Methods: L3～4, L4～5, L5～S1 disks of 68 consecutive cases with low back and lower extremity pain were scanned by CT before and after loading. The sagittal, coronal and oblique lengths of each disk were measured on CT, the anterior and posterior length of vertebral bodies from lower border of L1 to S1 were also measured before and after loading. Results: After loading the sagittal, coronal and oblique length of L3～4≥1mm in 31, 29 and 34 cases respectively. The lengths of L4～5 increase≥1mm after loading in 48, 32 and 34 cases respectively, and the lengths of L5～S1 increase≥1mm in 39, 33 and 38 cases respectively. The decrease of the anterior length of the vertebral body≤-1mm in 46 cases, decrease of the posterior length of the body≤-1mm in 38 cases after loading(P<0.01), the increase of the lengths of intervertebral disks after loading had statistical significance. Conclusion: CT scanning of lumbar vertebral disks after immitating loading can detect mild intervertebral disk bulgying and postrusion, and can guide clinical treatment.