非骨性腰椎管狭窄症脊髓造影和CT的对比研究

Correlation Study on the Flexion-Extension Myelography and Dynamic CT Scan on Non-Bony Lumbar Vertebral Canal Stenosis

通过１２例Ｌ４，５间盘突出的腰椎管狭窄症伸屈脊髓造影和伸屈ＣＴ扫描，测量分析不同体位下突出椎间盘压迹深度或最大矢状径及黄韧带厚度的变化情况，结果表明：突出椎间盘在前屈位突出最小，后伸位突出最大，差异非常显著（Ｐ＜０．０１）；黄韧带厚度前屈位小于后伸位，差异非常显著（Ｐ＜０．０１）。结合以前研究，［１］我们认为对于非骨性段腰椎管狭窄症腰椎前屈位可以使突出椎间盘和肥厚黄韧带对硬膜囊和神经根的压迫减少，狭窄程度减轻，有利于临床症状缓解。

Flexion-extension myelography and dynamic CTscan on lumbar spinal stenosis with the prolapses of lumbar intervertebral disc at L 4,5 were applied respectively in twelve cases to analyze the changes of the largest anterior-posterior widths (or the largest compressed depths) of protruded lumbar intervertebral disc and the thicknesses of ligamentum flavum at L 4,5 level in different positions.The results showed that the anterior-posterior widths and the thicknesses were less under flexion than under extension.Dynamic changes of both were more significant (P<0.01).Connecting with authors' former study,the authors realized that flexing lumbar vertebra could reduce the degree of protruded lumbar intervertebral disc and hypertrophic ligamentum flavum compressing nerve roots and the dural sac,and that less became the stenosis degree of non-bony lumbar vertebral canal.So flexing lumbar verteabral could relieve favorably the clinical symptoms.