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Scoliosis Research Society
SRS: Scoliosis Research Society

Scoliosis Research Society

竭诚为患者的脊柱畸形的最佳治疗

特发性脊柱侧凸

成人

影像学研究

站立位全脊柱正侧位全长X线检查,包括所有脊柱节段以及骨盆和臀部,是评估成人脊柱畸形不可缺少的(图1A,B)。通过X射线检查,可以评估脊柱节段,区域性弯曲和整体躯干平衡(整体定位)。侧位片时,臀部和膝盖保持直立对于了解脊柱畸形是非常重要的(图1C和D)。支点成像是评估脊柱柔韧性必须的检查(屈曲位)。当评估伴有下肢症状或其他神经系统的体征或症状的患者时,则需要更先进的影像学检查(如MRI或CT脊髓造影)(图2)。

A and B) Front and side X-rays showing the entire spine and hips.  C and D) Make sure the knees and hips are straight on the side X-rays.  (C) shows the patient in the compensated (knees bent) position, while (D) shows them standing with their knees straight.

Figure 1: A and B) 正侧位X线检查包括所有脊柱节段以及骨盆和臀部C and D) 确保侧位X线时,髋关节和膝关节是直立状态; C) 患者处于强迫体位(膝关节屈曲); (D) 显示患者膝关节直立状态。

A front view of the lumbar spine.  Yellow arrows show “olisthesis” (advanced rotation) and green arrows show tight regions causing pinched nerves.  B) Myelogram – with the introduction of dye, the nerves can be seen on X-ray.  The blue arrow shows a “dent” – pinched nerve blocking the dye.  C) MRI of L4-L5 showing spinal stenosis (pinched nerves). D) CT myelogram of the same level.  Without myelogram contrast, it is difficult to see nerves on CT.

Figure 2: A) 腰段正位X线,黄箭头显示“滑移”(旋转),绿色箭头显示椎间隙变窄,神经根受压迫 B) 脊髓造影,通过X线可看到神经形态,蓝线位置显示受压迫神经。 C)MRI检查显示腰4-5椎管狭窄(神经根受压)。 D) CT显示相同节段,无脊髓造影对比,很难发现神经根。