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目的探讨因急性脊椎外伤X线检查而发生的争议及采取的对策。资料与方法本组12例,均有不同程度的急性外伤史。X线检查部位:颈椎3例,胸椎2例,腰椎7例。全部病例均摄正、侧位X线片,根据需要加照颈椎张口位片或斜位片。加做CT6例,MRI6例。结果张口位环枢椎片诊断半脱位不可靠,CT可准确观察有无脱位;椎体楔形变可以是急性压缩性或陈旧性骨折,MRI可根据信号改变作出鉴别;椎缘骨并非外伤所致,而是椎间盘脱出,MRI可明确诊断;真性和假性滑脱与急性外伤无关联,CT和MRI均可提供帮助。结论急性外伤脊椎X线诊断如发生上述争议,应采取的对策是根据不同情况加做CT或MRI检查。
Objective To discuss the controversy caused by acute X-ray examination of spinal cord injury and its countermeasures. Materials and Methods The group of 12 patients, all have different degrees of history of acute trauma. X-ray examination site: cervical 3 cases, 2 cases of thoracic and lumbar 7 cases. All cases are positive, lateral X-ray, according to the need to add cervical spine mouth piece or oblique film. Add CT6 cases, MRI6 cases. Results Zhang mouth bit of the Central axis of the diagnosis of subluxation is not reliable, CT can be accurately observed with or without dislocation; vertebral wedge deformation can be acute compression or old fractures, MRI can be identified according to the signal changes; vertebral bone is not caused by trauma , But the disc prolapse, MRI can confirm the diagnosis; true and false spondylolisthesis has no correlation with acute trauma, CT and MRI can provide help. Conclusion If acute spine X-ray diagnosis of the above-mentioned controversy occurs, the countermeasures should be taken according to different situations plus CT or MRI examination.