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目的探讨招收飞行学员体检中腰椎峡部裂的X线诊断要点。方法以27例诊断L5双侧峡部裂为研究对象,采用CR或DR机行立位拍摄腰椎正、侧、双斜位X线片,10例加做腰椎X线计算机断层扫描(X ray computedtomography,CT)并二、三维重建。结果正位片X线征象:①“裂隙征”显示率18.5%(5/27);②椎弓根下方密度增高及结构紊乱显示率48.1%(13/27)。侧位片X线征象:①峡部上下缘连续性中断,显示率85.2%(23/27);②峡部裂隙低密度影显示率85.2%(23/27);③脊柱1度滑脱占48.1%(13/27);④椎体后缘连线与棘突上缘连线交角:L5>L4型占44.4%(12/27),对照组除1例均L5L4;⑤正位片“裂隙征”;⑥正位片椎弓根下部分密度增高及结构紊乱;⑦斜位片椎板及峡部发育细小。①~②是诊断腰椎峡部裂的直接征象,③~⑦是诊断腰椎峡部裂的间接征象。侧位或斜位片有①或②任1项,腰椎峡部裂的诊断即可成立。侧位片有①或②任何1项加③,腰椎双侧峡部裂的诊断即可成立。
Objective To explore the X-ray diagnosis points of lumbar spondylolysis in the examination of flight trainees. Methods Twenty-seven cases of L5 bilateral isthmus were studied in this study. Radiographs of both sides of the lumbar spine were collected by CR or DR. X-ray computed tomography (X-ray computed tomography) CT) and two, three-dimensional reconstruction. Results The positive radiographs of the anteroposterior radiographs showed that 18.7% (5/27) of the fissure sign showed the density of the lower pedicle and 48.1% (13/27) of the structural disturbances. X-ray findings of lateral radiographs: ①continuity of upper and lower edge of isthmus was interrupted, showing a rate of 85.2% (23/27); ②low rate of isthmus showed 85.2% (23/27) 13/27); ④ vertebral trailing edge of the junction with the upper edge of the spinous process: L4> L4 accounted for 44.4% (12/27), except 1 case in the control group were L5 L4; Bit slice “fissure sign ”; ⑥ anteroposterior pedicle partial density increased and structural disorders; ⑦ oblique plate lamina and isthmus small. ① ~ ② is a direct diagnosis of lumbar spondylolysis signs, ③ ~ ⑦ is an indirect diagnosis of lumbar spondylolysis signs. Side or oblique film has ① or ② any one, lumbar spondylolysis can be established. Lateral films are ① or ② any one plus ③, lumbar spondylolysis diagnosis can be established.