脊柱滑脱对腰椎峡部裂的诊断价值及两种测量方法比较

Diagnostic value of spondylolisthesis in lumbar vertebral laminar spondylolysis and comparison of measuring accuracy between two methods

目的探讨脊柱滑脱对腰椎峡部裂的诊断价值,比较Meyerding与Taillard方法测量的准确性。方法以招收飞行学员的52例L5双侧峡部裂者作为研究对象,取立位腰椎侧位X线片,分别按Meyerding和Taillard方法测量L5椎体滑脱的程度,计算阳性率,分析滑脱对峡部裂诊断的意义。结果侧位片按Meyerding和Taillard方法测量,L5滑脱率分别为40.38%(21/52)和86.54%(45/52),Taillard较Meyerding测量方法更精细准确(P<0.05)。结论 L5脊柱滑脱是L5峡部裂诊断的重要间接X线征象,它不仅说明峡部裂的存在,也说明了双侧性;采用Taillard法测量L5滑脱较Meyerding法更准确。在招收飞行员体检和青年人腰椎疾病诊断中,侧位片脊柱滑脱高度提示相应椎体峡部裂的诊断。

Objective To investigate the diagnostic value of spondylolisthesis in lumbar vertebral laminar spondylolysis and compare the measuring accuracy between Meyerding and Taillard methods.Methods 52 cases of bilateral spondylolyis of L5 confirmed in health examination for pilot recruitment were included in this study.According to lateral X-ray films taken in the erect position,the degree of spondylolisthesis of L5 was measured using Meyerding and Taillard methods,respectively,and their positive rates were calculated.Then the significance of spondylolisthesis in the diagnosis of spondylolysis was analyzed.Results On lateral view,spondylolisthesis of L5 accounted for 40.38%（21/52）with Meyerding method and 86.54%（45/52）with Taillard method.The difference was statistically significant（P0.05）.Taillard method was more accurate than Meyerding method.Conclusion Spondylolisthesis of L5 is an important indirect sign in the diagnosis of vertebral laminar spondylolyis of L5,which not only indicates its presence,but also did bilateral lesions.Using Taillard method to measure spondylolisthesis of L5 is more accurate than using Meyerding method.In health examination for pilot recruitment or diagnosis of lumbar diseases of young adults,the presence of spondylolisthesis on lateral view of lumbar spine would highly implicate spondylolysis of corresponding vertebra.