摘要
作者对１２０例因下腰痛手术治疗在术前进行过ＣＴＭ检查的患者作了影像学及临床分析．按形态不同，侧隐窝可分为五种类型：（１）三角型，即整个椎管呈倒三角形，其侧隐窝完全开放；（２）猫耳型，因后关节和椎体后缘轻度增生，形成底宽顶尖的侧隐窝，整个椎管形如猫头，侧脸窝为猫耳，基本开放；（３）牛角型，因关节突向椎体方向过度增生使侧隐窝呈横向伸开的带状，中央椎管不窄，横断面形如牛头，侧阴窝为牛角，严重者侧隐窝可近于闭塞；（４）三叶草型，极度增生的关节突加上向后实入的椎体后缘使整个椎管呈三叶草状，侧隐窝和中央椎管均狭窄；（５）混合型，多为上述形状的混合或两侧侧隐窝发育不对称．前二型不易形成对神经的压迫，后三型易造成压迫．但即使最狭窄的侧隐窝也不一定产生症状，因为关键在于神经根和侧隐窝的宽度的相对关系．因此作者提出单纯依靠侧隐窝的宽度不能诊断侧隐窝狭窄症，而是要判断神经是否被侧隐窝压迫．因此ＣＴＭ在侧隐窝狭窄症的诊断中有突出意义．
The authors analysed the results of pre-operative CTM and clinical data in 120 patients undergoing decompressive surgery for low back pain. Morphologically, their lateral recesses were classified as following five types: take Ⅰ. triangle, ie, the whole spinal canal shown as a reversed triangle shape with totally opened lateral recesses; tabs ; Ⅱ. cat ear,ie, the canal shown as a cat head and the partially opened lateral recess as its two cars ; type Ⅲ ox horn, the posteriorly protrused hypertrophic facets leading to a narrowing lateral recess without central canal stenosis, consequently the central canal shown as a bead and the lateral recesses as two horns ; type Ⅳ. trilobed type, the severe hypertrophy of facets and posterior margin of vertebralbody causing both the central canal and lateral recess stenosis, shown as trilobed ; type Ⅴ. mixed type,the cambination of the types described above or congenital asymmetry of lateral recesses. For type Ⅰ and Ⅱ, the possibility of the development of nerve root compression is low, and for type Ⅲ, Ⅳ and Ⅴ, the possibility may be much higher. However, it should be emphasized that the narrowest lateral recess would not Cause any clinical symptom which depends upon the anatomic relationbetween the lateral recess and nerve root. Therefore,the authors suggest that the diagnosis of lateral recass syndrome should be based on the evidence of compression of nerve root ; other than the sagitai distance of bony lateral recess;and in this view, CTM is of greater significance in its diagnosis.
出处
《CT理论与应用研究（中英文）》
1995年第1期37-41,共5页
Computerized Tomography Theory and Applications
