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《最新Magnetic Resonance Imaging of Spondylolysis and Spondylolisthesis峽部裂及腰椎滑脫癥的磁共振成像教學講義PPT.ppt》由會員上傳分享，免費在線閱讀，更多相關內容在教育資源-天天文庫。
1、MagneticResonanceImagingofSpondylolysisandSpondylolisthesis峽部裂及腰椎滑脫癥的磁共振成像PartI:StaticmagneticresonanceimagingIncidenceofvertebralhypoplasiaImpactofvertebralhypoplasiaonmeasurementandclassificationPartII:PositionalmagneticresonanceimagingPositionalMRIfindingsClinicalimplicationofpositionalMRfindi
2、ngsStaticmagneticresonanceimagingMethodsII:MRIinseatedpositionusingtheFONARUprightMRI=>sagittalT2weightedscanDELineD:lowermarginofL5LineE:uppermarginofS1DifferenceinsizebetweenLineAandlineBinmmMethodsIII:CEGradeMeyerding:CdividedbyEin%Hypoplasia:EminusDinmmRealSpondylolisthesis:C–HypoplasiaRealSl
3、ip(Meyerding):C-Hypoplasia/EControl:Groupof526patientswithoutspondylolysisorspondylolisthesis=>IsL4smallerthanL5orL5smallerthanS1?=>Dorsalalignment?DResultsI:Hypoplasiawasfoundin62levelsoutof184(L5:61,L4:1)Rangeofhypoplasia:3to13mm(5+/-2mm)Hypoplasia(classic):Grade0:0Adjusted:Grade0:24GradeI:37Gr
4、adeI:31GradeII:24GradeII:7GradeIII:1In41patientsthegradeofsliphadtobeadjusted!24patientswerereclassifiedasspondylolysis!ResultsII:Hypoplasiawasfoundin10levelsin526controls(p<0.001).L5washypoplasticin8patients(8outof526)L4washypoplasticin2patients(2outof526)Hypoplasiawas3to4mminthecontrols.Nottake
5、nintoaccountwereotherhypoplasia(S1,combinedhypoplasia,ventralhypoplasia)ConclusionI:Hypoplasiaiscommoninspondylolysis34%ofallsegments,39%oflevelL5HypoplasiamightmimicspondylolisthesisGradingafterMeyerdingtakesnotintoaccounthypoplasiaCarefulnottomisdiagnosespondylolysisasspondylolisthesis,whenhypo
6、plasiaispresentMeasurethehypoplasiaandgradeaccordinglyConclusionII:PathogeneticimplicationsIstheshorteningacquiredorinborn?Hypoplasiaexistsinnonspondylolyticvertebrae,butisrare=>Hypoplasiaispredisposition?Inborn:mightexplainfamilypredispositionisfoundinpatientswithoutspondylolysisAcquired:mightbe
7、acquiredduringgrowthboneovergrowthatthefracturesitegrowthofthevertebralbodyhinderedPositionalmagneticresonanceimagingStabilityofthelumbarspinePanjabi(1980)definesspinalinstabilityas”thelossoftheabilityofthespineunderph
