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目的探讨腰椎动力位X线片对腰椎不稳及不典型滑脱的诊断价值。方法测量22例怀疑腰椎滑脱及不稳定患者的腰椎常规侧位X线片与动力位(过伸、过屈侧位)片在椎体位移度、相邻椎体矢状曲度(矢状曲度的测量采用相邻椎体上终板垂线之夹角)以及椎间隙角度上的差异。结果椎体位移度在过屈位与常规侧位(P=0.000)、过屈位与过伸位(P=0.000),过伸位与常规侧位(P=0.027)差异有统计学意义;相邻椎体矢状曲度在过屈位与常规侧位(P=0.001)、过屈位与过伸位(P=0.000)差异有统计学意义,过伸位与常规侧位无统计学意义(P=0.184);椎间隙角度在过屈位与常规侧位(P=0.002)、过屈位与过伸位(P=0.000)差异有统计学意义,过伸位与常规侧位无统计学意义(P=0.131)。椎体矢状曲度与椎间隙角在常规侧位(P=0.001)及过屈位(P=0.026)上存在相关性。结论腰椎动力位X线片对腰椎不稳及腰椎不典型滑脱的诊断具有重要价值。
Objective To investigate the diagnostic value of lumbar dynamic X-ray on lumbar instability and atypical spondylolisthesis. Methods Twenty-two patients with suspected lumbar spondylolisthesis and unstable lumbar spondylolisthesis were measured with respect to vertebral body displacement, adjacent vertebral sagittal (sagittal curvature Degree measurement using the adjacent vertebral vertical plate angle between the angle) and the difference in the angle of the intervertebral space. Results The degree of vertebral body displacement had statistical significance between the flexion position and the conventional lateral position (P = 0.000), the flexion and extension position (P = 0.000), the extension position and the conventional lateral position (P = 0.027) The sagittal curvature of the adjacent vertebral bodies in varus and conventional lateral (P = 0.001), flexion and extension (P = 0.000), the difference was statistically significant, hyperextension and conventional lateral no statistical (P = 0.184). The intervertebral space angle was statistically significant between the flexion position and the conventional lateral position (P = 0.002), and between the flexion position and the over extension position (P = 0.000) Statistical significance (P = 0.131). There was a correlation between the sagittal curvature of the vertebral body and the intervertebral angle in the common lateral position (P = 0.001) and flexion position (P = 0.026). Conclusion The lumbar dynamic X-ray is of great value in the diagnosis of lumbar instability and lumbar atypical spondylolisthesis.