X线与CT对腰椎间盘突出症的诊断价值及临床意义

X -ray and CT Diagnosis of Lumbar Disic Herniation and Clinical Significance.

目的探讨腰椎间盘突出突出症的腰椎平片与CT的影像学特点及临床意义。方法回顾性分析60例经手术证实为腰椎间盘突出症患者的腰椎平片和CT的影像资料。结果①腰椎平片：56例有不同程度的退行性改变，如生理曲度异常、椎间隙宽度改变、Schmorl结节、骨质增生等，其中5例伴椎体滑脱。②CT表现：60例均能直接显示突出物和压迫征象（如硬膜囊、神经根受压变形、移位），53例发现伴发征象（黄韧带肥厚、椎体及小关节骨赘、侧隐窝狭窄等），以L4-5、L5～S1为好发部位。结论腰椎平片不能确定椎间盘突出的位置和程度，但根据某些征象及临床症状可作出初步诊断；CT能清晰直观地显示椎间盘突出的位置、方向和程度以及硬膜囊、神经根受压情况，CT对定位、定性诊断比较准确。因此，X线平片与CT对腰椎间盘突出的诊断具有重要临床意义。

Objective To study X - ray and CT image study characteristic and significance of Lumbarintervertebral disc herniation. Methods Review analysis 60 cases confirm after the surgery for the Lumbar intervertebral disc hernia patients, X - ray and the CT image data. Results （1）X- ray ：56 cases have the varying degree change for degenerative spinal disease, such as abnormal physiological curvature, lumbar intervertebral space change, Schmorl tubercle, hyperostosis and so on,5 examples centrum Watt. （2）CT performance：60 cases can directly demonstrate the overhang and the oppression drafts likely （for example hard membrane pouch, nerve root bearing distorts, shifting） ,53 cases discovered the partner sends drafts likely （ligament flava plump, centrum and small Joint Ossein hyperostesis, lateral recess syndrome and so on） , take the L4-5 ,L5 - S1 for position. Conclusion Lumbar vertebra plain film cannot determine the intervertebral disc prominent position and the degree, but acts according to somewhat drafts likely and the clinical symptom may make the preliminary diagnosis;the CT clearly show demonstration the intervertebral disc prominent position, the direction and the degree ,dural and nerve root situation. CT to locates, the qualitative diagnosis quite is accurate. Therefore, X - ray and CT have the vital clinical significance to the Lumbar intervertebral disc hernia.