青少年腰椎间盘突出症的多层螺旋CT诊断

CT DIAGNOSIS OF ADOLESCENT LUMBAR INTERVERTEBRAL DISC PROTRUSION

目的探讨青少年腰椎间盘突出症(LIDP)的病因、临床及CT表现特点。方法回顾性分析26例LIDP病人的临床及CT表现。结果26例病人中,临床表现为腰痛伴下肢放射性疼痛13例(50.00%),直腿抬高试验阳性24例(92.31%),曲颈试验阳性20例(76.92%);20例(76.92%)有明显外伤史,6例(23.08%)无明显病因。CT表现:中央型16例(61.54%),旁中央型5例(19.23%),椎间孔型3例(11.54%),远外侧型2例(7.69%)。部位:L4-5椎间盘15例,L5-S1椎间盘10例,L3-4椎间盘1例。结论青少年LIDP临床上常表现为症状较轻而体征较明显的特点,病因主要是外伤和腰骶部发育异常;CT表现以中央型多见,其次为旁中央型,伴发征象少,与成人不同。

Objective To investigate the pathogenesis, clinical manifestations and CT findings of adolescent lumbar intervertebral disc protrusion （LIDP）. Methods The clinical manifestations and CT findings in 26 teenagers with LIDP were retrospectively analyzed. Results The manifestations and findings were as follows： low back pain accompanied with radiated pain in lower extremity （13 cases）; positive straight-leg raising test （24） and positive neck-bending test （20）. CT： central type （16）; paracentral type （5）; lateral type （3）; apo-lateral type （2）. Location of the LIDP： L4/5 （15 cases）; L5/S1 （10）; L3/4 （1）. Conclusion Teenage LIDP shows slight symptoms but obvious signs, caused mainly by trauma and lumbosacral dysplasia. On CT, mostly of central type, followed by paraeentral, with few associated signs, which is different from that in adults.