【作者】 叶盛；

【导师】 廖文波；

【作者基本信息】 遵义医学院 ， 骨外科， 2010， 硕士

【摘要】 目的：探讨腰椎管狭窄的原因、完善腰椎管狭窄的诊断标准。方法：对2008年1月至2009年7月间行腰椎CT检查无腰椎退行性变的病例57例(A组)及2005年3月至2009年6月间我院收治的下腰椎关节突关节脱位伴有坐骨神经痛的病例47例(B组)的CT片进行测量,所有的CT扫描平行于椎体终板,分别测量L4、L5椎左右两侧上位下关节前缘至下位椎体后上缘距离即突椎间距。分析B组中突椎间距变化与脊神经根性症状的关系,对两组患者的测量结果进行统计学分析,并计算B组突椎间距单侧95%可信区间,作为腰椎管狭窄的参考标准。结果：A组中L4、L5椎体左、右两侧突椎间距值分别为：L4:10.874±0.767mm,10.853±0.766mm; L5:11.544±1.063 mm,11.609±0.963 mm；B组突椎间距值：L4：3.254±1.518mm；L5：3.568±1.299mm。A组同一椎体左右两侧的突椎间距比较无统计学意义(P>0.05),同侧L4、L5椎体突椎间距比较有统计学意义(P<0.05)。A、B两组同椎体突椎间距比较有差异(P<0.01),B组单侧95%医学参考值范围为：L4：5.731mm；L5：5.705mm。结论：下腰椎关节突关节脱位中突椎间距变窄,下关节突前移是致椎管狭窄的重要原因之一；突椎间距单侧95%医学参考值可作为腰椎管狭窄诊断参考指标。更多还原

【Abstract】 Objective To investigate cause and to consummate diagnostic standard of lumbar spine stenosis. Methods:A total of 57 cases with no lumbar degeneration by CT scans (group A) from January 2008 to July 2009 and 47 cases with inferior lumbar zygapophysial Joint pre-dislocation and with sciatic neuralgia (group B) from March 2005 to June 2009 were studied. The all CT scans were be at equal pace of terminal plate of vertebral body. The CT scans of each patient were measured.Measurement parameters are distance from hypozygal anterior border to following vertebral body upper posterior border of L4 and L5 with right and left sides(distance between hypozygal and next lumbar). Analyze the relation between distance change and Spinal nerve root symptomatic in group B.Measurements data was analyzed with statistics. The 95% confidence interval of distance between hypozygal and next lumbar was calculated in group B, which was defined as diagnostic standard of lumbar spine stenosis. Result:the distance between hypozygal and next lumbar with left and right at L4、L5 vertebral body in group A:L4:10.874±0.767mm,10.853±0.766mm; L5: 11.544±1.063 mm,11.609±0.963 mm. The distance between hypozygal and next lumbar in group B:L4:3.254±1.518mm; L5:3.568±1.299mm. The right distance between hypozygal and next lumbar in group A is no more than distance of the left side(P>0.05) at the same vertebral body. But the distance at the same side is differential beteen L4 and L5(P<0.05). The distance in group A is obviously greater than in group B at the same vertebral body(P<0.01).The 95% confidence interval was defined as lumbar spine stenosis of less than 5.731mm in L4 and less than 5.705mm mm in L5. Conclusion:inferior lumbar zygapophysialJoint dislocation is one of reasons that cases lumbar spine stenosis; The 95% confidence interval of distance between hypozygal and following lumbar may use as diagnostic standard.更多还原