脊柱全长X线片对非矩形化腰椎骶化的诊断价值

The value of whole spine plain radiograph for the diagnosis of non-squaring lumbar-sacralized vertebra

目的:探讨脊柱全长X线片对非矩形化腰椎骶化的诊断价值。方法:2008年8月～2009年7月共153例腰腿痛并颈部或胸背部不适的患者接受脊柱全长X线片检查,男84例,女69例,年龄14～82岁,平均47.9±13.7岁。观察其脊柱全长X线片,明确是否有腰椎X线平片难辨出的腰椎骶化。结果:共发现7例腰椎X线平片难辨出的非矩形化完全型腰椎骶化,男5例,女2例,年龄21～60岁,平均39.7±13.7岁。所有骶化的椎体均为正常S1椎体矩形化表现,下方椎间隙为正常S1/2椎间融合表现。合并颈肋2例,第12肋骨缺如4例。结论:脊柱全长X线片能确诊单纯腰椎X线平片难以明确的非矩形化腰椎骶化。

objective：To investigate the value of whole spine plain radiograph for the diagnosis of non-squaring lumbar-sacralized vertebra.Method：Between August 2008 and July 2009,153 consecutive cases who took whole spine plain radiograph due to low back pain and sciatica combined with cervical scapula discomfort were enrolled in the study.There were 84 males and 69 females with an average age of 47.9±13.7 years（range,14 to 82 years）.Everyone＇s whole spine plain radiograph were reviewed to verify whether sacralized vertebra were ignored.Result：7 cases with non-squaring sacralized vertebra were missed as normal lumbosacral structure under lumbar plain radiographs alone.Among them,there were 5 males and 2 female with an average age of 39.7±13.7 years（range,21 to 60 years）.All sacralized vertebra exhibited normal S1 vertebra shape with its lower disc exhibiting normal fused S1/2 intervertebral disc appearance.2 were complicated with cervical ribs of the 7th cervical vertebra while 4 had the 12th ribs absence.These pitfalls could only be identified and corrected under whole spine radiograph.Conclusion：Non-squaring sacralized vertebra may be missed as normal lumbosacral structure under lumbar plain radiographs alone.Whole spine plain radiograph is recommended.