腰椎功能位与侧卧位平片对腰椎位移诊断价值的比较

The comparison of radiography of lumbar functional position and lateral position in the diagnosis of lumbar spondylolisthesis

目的:比较腰椎功能位、侧卧位X线平片对腰椎位移诊断的价值,为临床选择腰椎位移X线检查的正确方法提供依据。方法:对62例腰腿痛和坐骨神经痛的患者,分别通过自制的腰椎功能位体位架进行站立最大伸位、最大屈位和常规侧卧位状态下拍摄腰椎侧位X线片,测量和诊断有无腰椎位移及其程度,进行统计学分析与比较。结果:该组62例显示腰椎位移共计36例,常规侧卧位阳性仅25例,功能位显示阳性36例,其中过伸位34例,过曲位29例,经统计学分析,P<0.05,有显著性差异。腰椎位移程度功能位较侧卧位有显著的加重趋向,P<0.01,有统计学意义。结论:功能位更能反映腰椎位移的实际程度,自制的辅助体位架为腰椎功能位检查提供了良好的保障。

Objective：To compare the value of radiography of lumbar functional position and lateral position in the diagnosis of lumbar spondylolisthesis,to explore the right methods of X-ray examination about lumbar spondylolisthesis.Methods： Sixty two patients with lumbocrural pain and sciatica were underwent the radiographies of lumbar spine,which were respectively obtained three photographies under the states of the hyper-extended position,hyper-flexed position and conventional lateral position by self-made planes,The degree of lumbar spines displa ement under the different positions were measured and compared.Results： 36 patients were diagnosed with lumbar spondylolisthesis.Of which,25 cases were diagnosed by photographied under the conventional lateral positions,but 34 cases under the hyperextended position and 29 cases under the hyper-flexed position.There was a significant difference between lumbar functional positions and conventional lateral positions.lumbar functional position has more serious tendency than lateral position in the degree of lumbar spine displacement（P0.01）,the difference had statistically significance.Conclusion： functional X-ray examination methods can reflect the actual extent of displacement of lumbar preferably.The self-made assistant frame can provide good protection for lumbar function position radiography.