摘要
目的探讨数字X线摄影两种检测体位在腰椎退变性不稳患者腰椎生理功能诊断中的应用及其差异。方法选取2014年1月至2016年12月接受诊治的退行性腰椎不稳患者118例,分别进行常规卧位腰椎功能位(常规法)和生理负重腰椎功能位(生理负重法)摄影。X射线片质量按影像清晰度、伪影分为甲、乙、丙三级。观察比较采用生理负重法与常规法检查的数字X线摄影图像质量、椎体位移程度及椎体椎间成角程度等数据。结果生理负重法检查的甲级、乙级、丙级图像所占比例分别为83.05%、15.25%、13.56%,常规法分别为83.90%、14.41%、13.56%,两种方法差异无统计学意义(P>0.05)。常规法侧卧位检查的椎体位移在L5、S1过屈位为(4.62±0.23)mm、过伸位为(4.94±0.29)mm,明显低于生理负重法检查[过屈位(4.90±0.23)mm、过伸位(5.29±0.28)mm,P均<0.05];常规法侧卧位检查的椎体位移在L4~5过屈位为(4.52±0.24)mm、过伸位为(4.85±0.23)mm,明显低于生理负重法检查[过屈位(4.76±0.29)mm、过伸位(5.17±0.29)mm,P均<0.05]。常规法侧卧位检查的椎体椎间成角在L5~S1过屈位为(11.62±0.25)°、过伸位为(13.54±0.29)°,明显低于生理负重法检查[过屈位(12.71±0.26)°、过伸位(14.57±0.32)°,P均<0.05];常规法侧卧位检查的椎体椎间成角在L4~5过屈位为(10.62±0.28)°、过伸位为(11.56±0.23)°,明显低于生理负重法检查[过屈位(12.09±0.56)°、过伸位(12.59±0.27)°,P均<0.05]。结论生理负重功能位数字X线摄影较常规检查方法的效果更为显著,更能明确反映腰椎矢状位位移程度、曲度的变化。
Objective To explore the application and its differences of digital X-ray photography by two detection postures in the diagnosis of lumbar physiological function in patients with lumbar degenerative instability. Methods A total of 118 DLI patients were selected from January 2014 to December 2016 in whom DR photography by routine functional lumbar position（ routine examination）and physiological weight-bearing lumbar function position （physiological weight-bearing examination）were performed respectively. The quality of X-ray film was divided into grade A, B and C according to the image definition and artifact. The quality of DR ,the degree of vertebral displacement and the angulation degree of vertebral bodies and intervertebral disks were observed and compared between two DR methods. Results The proportion of class A, B and C image film was respectively 83.05%, 15.25%, 13.56% in physiological weight-bearing examination and 83.90% , 14. 41%, 13.56% in routin examination. There were no statistical differences between two methods （ P 〉 0.05 ）. The vertebral displacement in routine examination was （4. 62 ±0. 23） mm in L5 and S1 flexion,and （4.94 ±0. 29） mm in hyperextension respectively, and （ 4. 90 ± 0. 23 ） mm in flexion, （ 5.29 ± 0. 28 ）mm in hyperextension respectively in physiological weight-bearing examination. The data of routine examination was statistically lower than that of physiological weight-bearing examination （all P 〈 0. 05 ）. The vertebral displacement in routine examination was （4. 52 ± 0. 24 ） mm in L4-5 flexion,and （4. 85 ±0. 23） mm in hyperextension,respectively and （4. 76 ±0. 29）mm in flexion, （5. 17 ±0. 29）mm in hyperextension respectively in physiological weight-bearing examination. The data of routine examination also was statistically lower than that of physiological weight-bearing examination （ all P 〈 0.05 ）. The angulation degree of vertebral bodies and intervertebral disks in routine examination was （ 11.62 ±0. 25）° in L5 and S1 flexion position, （ 13.54 ±0. 29）° in hyperextension position and was respectively significantly lower than those [ （ 12. 71 ± 0. 26 ）°, （ 14. 57 ± 0. 32 ） °] in weight-bearing examination （ all P 〈 0.05 ） ; it was （ 10.62 ± 0.28 ）° in L4 -5 flexion position, （ 11.56 ± 0.23 ）° in hyperextension position in routine examination and was respectively significantly lower than those [ （12. 09 ± 0. 56 ）°, （12.59 ±0.27）°] in physiological weight-bearing examination （all P 〈0.05）. Conclusion The DR by physiological weight-bearing radiography examination has more effect on clearly reflecting the changes of sagittal displacement and curvature of lumbar spines than by routine lateral pesition examination.
出处
《中国临床研究》
CAS
2018年第1期115-118,共4页
Chinese Journal of Clinical Research
基金
国家自然科学基金资助项目子课题(39770203
39640004)
关键词
腰椎不稳
退行性
腰椎生理功能
数字X线摄影
常规卧位腰椎功能位
生理负重腰椎功能位
椎体位移
椎体椎间成角
Lumbar instability, degenerative
Lumbar physiological function
Digital radiography
Routine lateral lumbar function position
Physiological weight-bearing lumbar function position
Vertebral displacement
Angulation of vertebral body and intervertebral disk
