目的探讨多层螺旋CT(MSCT)负荷检查在评估腰椎间孔(LIF)内神经根卡压中的价值。资料与方法利用自行研制的腰椎应力器对30例腰腿痛患者行MSCT检查,负荷前后各作1次螺旋扫描,范围包括整个LIF,在3个正交的平面上分别调整重建中心线使之与人体正交的3个平面平行,在冠状像上重组LIF的矢状平面,观察LIF内神经根的毗邻关系,将其分成4级:0级:神经根周围或前后下缘环绕脂肪;Ⅰ级:神经根前缘或后缘脂肪消失与LIF壁接触;Ⅱ级:神经根前后缘脂肪消失,与LIF壁接触,神经根可变形;Ⅲ级:神经根周围脂肪消失,神经根变形。以0~Ⅰ级神经根无卡压,Ⅱ级可疑卡压,Ⅲ级神经根受压为标准并结合临床评估LIF内神经根卡压情况。结果30例中,35个平面无椎间盘膨出/突出(A组),负荷前后神经根分级分别为:0级31个、Ⅰ级39个、Ⅱ~Ⅲ级0个和0级25个、Ⅰ级42个、Ⅱ级3个、Ⅲ级0个。负荷后9个LIF内神经根分级晋级,神经根分级Ⅱ~Ⅲ级3个(χ2=1.87,P>0.05)。55个平面椎间盘膨出/突出(B组),负荷前后神经根分级分别为:0级21个、Ⅰ级49个、Ⅱ级36个、Ⅲ级4个和0级15个、Ⅰ级32个、Ⅱ级47个、Ⅲ级16个,负荷后34个LIF内神经根分级晋级,显著高于A组(χ2=20.42,P<0.01),神经根分级Ⅱ~Ⅲ级63个显著高于负荷前40个(χ2=9.66,P<0.01)。负荷检查时30例均伴不同程度的腰腿痛;常规检查时仅17例伴不同程度的腰腿痛(χ2=9.29,P<0.01),且程度较轻。结论MSCT负荷检查较有效地评估腰椎退变LIF内神经根受压情况,有助于对隐匿性腰椎管狭窄的检出。 Objective To investigate the value of multislice spiral computed tomography (MSCT) load testing in assessing nerve root compression in lumbar intervertebral foramen (LIF). Materials and Methods Thirty patients with lumbar and leg pain were examined by MSCT before and after the operation, and spiral scans were performed before and after each load. The range included the entire LIF, and the center lines were adjusted and adjusted on three orthogonal planes respectively Parallel to the three planes perpendicular to the human body, reshaping the sagittal plane of the LIF in the coronal image, and observing the adjacent relationship between the nerve roots in the LIF and classifying them into four levels: level 0: fat around or around the nerve root; Grade: the anterior or posterior limb nerve of the nerve disappeared and the LIF wall contact; Grade II: the anterior and posterior limbal nerve fat disappeared, contact with the LIF wall, the nerve root can be deformed; Ⅲ grade: disappearance of fat around the nerve root, nerve root deformation. Nerve root compression without pressure, grade Ⅱ suspicious compression, grade Ⅲ nerve root compression as the standard and combined with clinical assessment of nerve root compression LIF situation. Results Of the 30 cases, 35 had no bulging / protrusion of the disc (group A). ​​The nerve root grading before and after the grading were: grade 0, grade I, grade 39, grade 0 to grade 0 and grade 0, grade 25 42, Ⅱ three, Ⅲ 0. The nerve root grading was promoted in 9 LIFs after loading, and the nerve root grading was 3 grade Ⅱ ~ Ⅲ (χ2 = 1.87, P> 0.05). Fifty-five planar disc herniation / prominence (group B). The nerve root grading before and after loading was 21 in grade 0, 49 in grade Ⅰ, 36 in grade Ⅱ, 4 in grade Ⅲ and 15 in grade 0, 32 in grade Ⅰ , 47 in grade Ⅱ, 16 in grade Ⅲ and 34 in LIF after loading, which were significantly higher than those in group A (χ2 = 20.42, P <0.01), and those in grade Ⅱ ~ Ⅲ of nerve root were significantly higher than those in group A The first 40 (χ2 = 9.66, P <0.01). During the load check, 30 cases had low back and leg pain in varying degrees. Only 17 cases had low back and leg pain (χ2 = 9.29, P <0.01) in routine examination with a slight degree. Conclusion The MSCT load test is more effective in evaluating the compression of nerve root in degenerative LIF of lumbar spine and is helpful for the detection of occult lumbar spinal stenosis.