摘要
背景:脊柱不稳经常被提及,但是很少有确切的定义,由于缺乏规整的临床经验或放射学准则的效果评价,所以仍然是一个有争议的概念。目的:对腰椎不稳症(尤其是退行性腰椎不稳症)的定义及诊断腰椎不稳症的影像学方法作一综述。方法:以"lumbar instability,traction spurs,ligament,disc space narrowing"等关键词在slide share、medlind和NCBI数据库筛选近30年的文献资料,语言种类为英文,最终纳入文章49篇。结果与结论:腰椎不稳症一方面可能是引起下腰痛和坐骨神经痛的病因,另一方面也常常被认为是决定脊柱融合和减压的一个重要条件。因其临床症状和体征无特异性,所以对此病的有效诊断和治疗也存在争议。功能性正侧位平片是腰椎不稳症影像学诊断使用最广泛最全面的一种方法。CT提供了更准确的脊柱退行性变和椎间关节方向的图像。磁共振通常被认为是诊断退行性脊椎改变最精确的成像方法,除了真空现象,常被用来诊断患者的慢性下腰痛。
BACKGROUND： Spinal instability, lacks of precise definition, is still a controversial concept due to lack of regular clinical experience or radiological evaluation. OBJECTIVE： To review the definition of lumbar spinal instability（especially degenerative lumbar spinal instability）and the imaging methods of diagnosing lumbar spinal instability. METHODS： We retrieved SLIDE SHARE, MEDLIND and NCBI database for literatures published in recent 30 years. Key words were ＂lumbar instability, traction spurs, ligament, disc space narrowing＂ in English. Finally 49 literatures were included. RESULTS AND CONCLUSION： Lumbar spinal instability possibly was a reason for low back pain and sciatica, and was a key condition for spinal fusion and decompression. Clinical symptoms and physical signs of lumbar spinal instability did not have specificity, so effective diagnosis and treatment for this disease are controversial. Functional lateral plain films are extensive important method to diagnose lumbar spinal instability. CT provides more exact images for spinal degeneration and intervertebral joint direction. Magnetic resonance is generally considered to be the most precise method for the diagnosis of degenerative changes in the spine, and has been widely applied to diagnose chronic low back pain besides vacuum phenomenon.
出处
《中国组织工程研究》
CAS
CSCD
2014年第22期3574-3580,共7页
Chinese Journal of Tissue Engineering Research
