腰椎后缘骨内软骨结节（附11例报告）

Intra-Osseous Cartilaginous Nodules over tbe Pos-terior Margin of the Lumbar Spine

作者分析了１１例腰椎后缘骨内软骨结节的临床、Ｘ线及ＣＴ表现。多为青壮年。主要症状为腰腿痛，均为单处发病。典型的Ｘ线表现为发病椎体后下缘有一骨质缺损，其后有一骨块突入椎管。ＣＴ扫描均见椎体后缘有类圆型或多囊状骨质缺损，为典型的软骨结节（许莫氏结节），结节的骨性后壁凸入椎管构成侧位Ｘ线片上的骨块。作者认为腰椎后缘骨内软骨结节多形成于青少年时期，是由椎间盘组织经破裂的软骨终板突入椎体后缘的松质骨内所致。当症状重体征明显时需外科手术。将骨和软骨块及突出椎间盘切除，可获满意疗效。

AbstractThe authors analysed the clinical manifestations,radiological and CT findings of 11 cases of intra-os-seous cartilaginous nodules over the posterior margin of the lumbar spine. There were 7 males and 4 females and most were adults. Low back and sciatic pain was the chief symptom.The typical radiological findings included a defect at the posterior inferior margin of the affected vertebral body and behind the defect a bony ridge protruding into the spinal canal.On CT scaning,around or multicystic defect with a dense peripheral margin,typical of a cartilaginous(Schmorl’s)node,can be seen in the posterior zone of the vertebral plate。The posterior bony margin of the cartilaginous node was convex and protruded into the spinal canal,forming the bony ridge seen on the lateral X-ray films.The authors believe that,the lesion was resulted from disc material herniating into the posterior aspect of the vertebral body through a ruptured cartilaginous end-plate during adolescence,When symptoms and signs warrant surgery,removal of the cartilaginous and bony fragment and discectomy of the affected interver-tebral space can achieve satisfactory results.