骶髂关节错位误诊单纯腰椎间盘突出症原因分析

Analysis of sacro-iliac articulation malposition misdiagnosed as single prolapse of lumbar intervertebral disc

目的明确骶髂关节错位误诊单纯腰椎间盘突出症的原因 ,确认骶髂关节错位的诊断要点 ,以便选择最佳的治疗方法。方法将 2 9例骶髂关节错位患者的腰骶部、骨盆X线片、CT片、及MRI片的生理弯曲、椎体间隙、关节间隙、耻骨联合、髂翼对比等变化和症状、体征 ,与相对应神经分布区域进行对照。结果 2 9例骶髂关节错位患者中 ,除其特有体征、症状外 ,X线片提示伴有脊柱退行性改变 2 6例、脊柱序列改变 17例 ,CT片、MRI片提示有椎间盘膨出 2 9例。按骶髂关节错位治疗 3— 10次后 ,痊愈 19例、显效 8例、好转 2例。结论骶髂关节错位虽与腰椎间盘突出症有多种相同症状、体征 ,但治疗方法截然不同 ,只需保守治疗。

ObjectiveTo find out the reason of sacro-iliac articulation malposition misdiagnosed as single prolapse of lumbar intervertebral disc, define the essential point of diagnosing sacro-iliac articulation malposition, and choose the best treatment.MethodsChanges such as X-ray photos of lumbosacral portion and pelvis, CT photos, physiological curvature, pyramid space, joint space, pubic symphysis, and wing of ilium showed in MRI photos, and symptoms, signs of 29 patients with sacro-iliac articulation malposition were analyzed and compared with distribution of nerve in the same part.Results29 patients with sacro-iliac articulation malposition all had bulge of lumbar intervertebral disc showed by CT and MRI photos, 26 had retrograde affection of spinal column, 17 had spinal column sequence changes showed by X-ray photos. After 3-10 times treatment on the basis of sacro-iliac articulation malposition, 19 healed, 8 were effective, and 2 had been better.ConclusionCurative method of sacro-iliac articulation malposition is different with prolapse of lumbar intervertebral disc, although there being many same symptoms and signs, only need conservative treatment.