脊柱全长片在腰骶移行椎诊断中的应用

Identify Lumbosaeral Transitional Vertebra by Whole Spinal Radiographs

目的：探讨脊柱全长片判定腰骶移行椎的准确性.方法：采用143例脊柱全长影像资料,分析其腰椎骶化（SZ）与骶椎腰化（LZ）分布情况,L5椎体与Tuffier线的关系及矩形化表现.结果：L5椎体在Tuffier线以下者男82.1%,女 79.7%.6例 IIIB型SZ椎体无矩形化表现,7例完全型LZ双侧横突高度小于19 mm.12例T12肋缺如单凭腰椎平片可能误为存在腰骶移行椎（LSTV）.结论：单纯腰椎平片无法避免漏误诊LSTV.只有脊柱全长片才能准确判定LSTV.

Objective： To identify the real distribution of sacralization and lumbarization by whole spinal radiographs. Methods： The whole spinal radiographic data from 143 lumbar-pain patients was analyzed to observe the distribution of lumbarization and sacralization, the relationship between L5 vertebral body and Tuffier＇ s line. Whether the lumbosacral transitional vertebra （LSTV） displayed a square-shaped appearance was also explored. Results ： The main parts of L5 vertebral bodies （ more than half of their heights） lower than the level of Tuffier＇s line were seen in 82. 1% of males and in 79.7% of females. Six cases of complete sacralization （Castellvi classification Type IIIb） failed to exhibit the square-shaped appearance. Seven cases of total lumbarization demonstrated that the heights of bilateral transverse processes were less than 19 mm. 12 cases with absence of 12th fibs might be misdiagnosed as LZ if only evaluated by lumbar plain radiographs. Conclusions： Pure lumbar plain radiographs might miss some virtual cases of LSTV and misdiagnose some ones with normal lumbar sequence and absence of 12th ribs as LSTV. Only whole spinal radiographs could guarantee the exact judgment to lumbar sequence.