腰椎椎体后缘离断症

Posterior Bony Edges Separation of lumbar Vertebrae

目的 :对 9例腰椎椎体后缘离断症进行回顾性分析。方法 :所有病例均行 X线片、CT扫描检查 ,其中 2例行MRI检查 ,并对照症状体征进行诊断 ,手术加以证实。结果 :病变主要见于 L4、5椎体后上缘或下缘 ,典型的 X线表现为病椎后角有一骨质缺损 ,其后有一骨块突入椎管 ;CT扫描均可见椎体后缘类园形或囊状骨质缺损 ,呈典型的许莫氏结节 ,椎体后缘突向椎管内的骨块与椎间盘髓核组织一起构成中央管或神经根管的狭窄 ,压迫马尾或神经根。结论 :椎体后缘离断的征象可能是青少年时期椎体后缘环状骨骺陈旧性损伤及其继发改变的结果 ,X线片、CT。

Objective:To retrospectively study the result of 9cases with posterior bony edges separation of lumbar vertebrae.Methods:All case examined with x-ray and CT scaning,MRI in two cases,and based on clinic symptoms and signs to diagnose.All cases be confirmed of surgical operation.Results:Most of lesions located in the posterosuperion or inferior edges of the L4.L5 vertebrae.The typical radiological findings included a defect at the posterior inferior margin of the affected vertebral body and behind the defect a bony ridge protruding into the spinal canal;On CT scaning,a round or multicystic defect with a dense peripheral margin,typical of schmol′s node,can be seen in the posterior zone of the vertebral plate.The bony ridge in the posterior edges of lumbar vertebrae which protruded into spinal canal and disc together lead to the central or nerve root stenosis,compressing the nerve root or cauda equina.Conclusion:The possible reason for the disease might be a secondary changes of the injury or variance of the epiphyseal ring of the vertebral body during the adolescent period.X-ray?CT scan and MRI play important roles in the diagnosis.