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目的 对腰椎小关节病CT表现作出归纳,提高对此病作为腰腿痛的重要病因的认识。方法 连续200例腰腿痛患者,主要作了腰椎L_(4-5)和L_5-S_1的小关节CT平扫,并运用骨窗和软组织窗对图像进行分析和测量。结果 有135例(占67.5％)患者表现为不同节段的腰椎小关节病,CT表现为:骨赘形成;小关节突增生肥大;关节间隙变窄;关节真空现象以及关节囊的钙化等。腰椎小关节病常伴有其它腰椎疾病。讨论 腰椎小关节病是引起腰腿痛的重要病因,常合并腰椎间盘突出症。由于以往捡查技术的局限以及过分强调了腰突症的作用,造成对此病的认识不足,CT具有快速、简单、准确、无创伤性等优点,是检查小关节病首选的影像学方法,对此病的诊断和治疗均有重要指导意义。作者还对椎小关节的解剖,椎小关节病的发病机理以及此病与推间盘病变的关系作了一定的探讨。
Objective To summarize the CT findings of lumbar facet joint disease and to raise awareness of this disease as an important cause of low back pain. Methods A total of 200 consecutive patients with low back and leg pain were included in this study. CT scan of L_ (4-5) and L_5-S_1 lumbar joints was performed. The images were analyzed and measured using bone window and soft tissue window. Results 135 patients (67.5%) showed different degrees of lumbar facet joint disease. CT showed osteophyte formation, facet hyperplasia hypertrophy, narrowing of joint space, joint vacuum and calcification of joint capsule. Lumbar facet joint disease is often accompanied by other lumbar diseases. Discuss Lumbar facet joint disease is an important cause of low back pain, often combined with lumbar disc herniation. Due to the limitation of previous techniques and the overemphasis on the function of lumbar disc herniation, which results in the lack of understanding of the disease, CT is a preferred imaging method for the detection of facet joint disease, which is rapid, simple, accurate and noninvasive. The diagnosis and treatment of the disease have important guiding significance. The author also made some discussion on the anatomy of facet joint, the pathogenesis of facet joint disease and the relationship between this disease and pushing disc disease.