腰椎关节突关节退变是导致下腰痛(low back pain)的主要原因之一,严重影响广大人民群众的生活质量。本文认真总结近年来国内外学者对于腰椎关节突关节退变的研究进展,概括了关节突退变的X线、CT及MRI表现及其临床意义,尤其是MRI表现国...腰椎关节突关节退变是导致下腰痛(low back pain)的主要原因之一,严重影响广大人民群众的生活质量。本文认真总结近年来国内外学者对于腰椎关节突关节退变的研究进展,概括了关节突退变的X线、CT及MRI表现及其临床意义,尤其是MRI表现国内相关报道较少,旨在为国内学者今后进行相关领域更深入的临床研究提供思路和参考。展开更多
目的：探讨轴位腰椎小关节和椎间盘M R T2＊mapping成像的可行性，明确T2＊mapping定量成像技术对小关节和椎间盘早期退变的评估价值。方法收集慢性下腰痛患者22名作为病例组，性别和年龄匹配的健康志愿者20名为正常对照组，采用3．0T M...目的：探讨轴位腰椎小关节和椎间盘M R T2＊mapping成像的可行性，明确T2＊mapping定量成像技术对小关节和椎间盘早期退变的评估价值。方法收集慢性下腰痛患者22名作为病例组，性别和年龄匹配的健康志愿者20名为正常对照组，采用3．0T M RI对两组行T2＊mapping及常规T2 WI成像，根据Weishaupt分级法、Pfirrmann分级法分别对L2～ S1各节段小关节和椎间盘进行形态学分级，并测量小关节和椎间盘的 T2＊值，进行对比分析。结果不同Weishaupt分级小关节的T2＊值差异无统计学意义（ P＞0.05）。不同Pfirrmann分级椎间盘髓核的T2＊值差异有统计学意义（ P ＜0．05）。小关节与后纤维环的T 2＊值呈弱相关性（ r‐0．3874）。病例组与对照组小关节的 T 2＊值很相近，而髓核的T2＊值差异有统计学意义（ P ＜0．05）。在小关节评价的组间一致性方面，T2＊值的一致性很好（ r ＝0．835，P ＜0.05）；形态学Weishaupt分级一致性较差（kappa＝0．327）。结论此研究表明T2＊ mapping可用于软骨的定量研究，且轴位的腰椎小关节和椎间盘T2＊mapping联合成像是可行的。展开更多
Spinal pain(SP)is a common condition that has a major negative impact on a patient’s quality of life.Recent developments in ultrasound-guided injections for the treatment of SP are increasingly being used in clinical...Spinal pain(SP)is a common condition that has a major negative impact on a patient’s quality of life.Recent developments in ultrasound-guided injections for the treatment of SP are increasingly being used in clinical practice.This clinical expert consensus describes the purpose,significance,implementation methods,indications,contraindications,and techniques of ultrasound-guided injections.This consensus offers a practical reference point for physicians to implement successfully ultrasound-guided injections in the treatment of chronic SP.展开更多
Objective： To explore the patterns of innervation of cervical facet joints and determine the pathways from facet joints to dorsal root ganglions （DRGs） in order to clarify the causes of diffuse neck pain, headache,...Objective： To explore the patterns of innervation of cervical facet joints and determine the pathways from facet joints to dorsal root ganglions （DRGs） in order to clarify the causes of diffuse neck pain, headache, and shoulder pain. Methods： Forty-two male Sprague-Dawley rats, weighing 250-300 g, were randomly divided into three groups： Group A （ n = 18） , Group B （ n = 18） , and Group C （ n = 6 ）. Under anesthesia with intraperitoneal pentobarbital sodium （45 mg/kg body weight）, a midline dorsal longitudinal incision was made over the cervical spine to expose the left cervical facet joint capsule of all the rats under a microscope. The rats in Group A underwent sympathectomy, but the rats in Group B and Group C did not undergo sympathectomy. Then 0.6 μl 5 % bisbenzimide （Bb） were injected into the C1-2, C3-4 and C5-6 facet joints of 6 rats respectively in Group A and Group B. The holes were immediately sealed with mineral wax to prevent leakage of Bb and the fascia and skin were closed. But in Group C, 0.9% normal saline was injected into the corresponding joint capsules. Then under deep reanesthesia with intraperitoneal pentobarbital sodium （45 mg/kg body weight）, C1 -C8 left DRGs in all rats and the sympathetic ganglions in Group B were obtained and the number of the labeled neurons was determined. Results ： Neurons labeled with Bb were present in C1- C8 DRGs in both Group A and Group B, and sympathetic ganglions in Group B. In the C1-2 and C3-4 subgroups, labeled neurons were present from C1to C8 DRGs, while in C5-6 subgroups they were from C3 to C8. The number of Bb （＋） neurons after sympathectomy was not significantly different in the injected level from that without sympathectomy. But in the other levels, the number of Bb （ ＋ ） neurons after sympathectomy was significantly less than that without sympathectomy. Conclusions： The innervation of the cervical facet joints is derived from both sensory and sympathetic nervous system, and DRGs are associated 展开更多
文摘腰椎关节突关节退变是导致下腰痛(low back pain)的主要原因之一,严重影响广大人民群众的生活质量。本文认真总结近年来国内外学者对于腰椎关节突关节退变的研究进展,概括了关节突退变的X线、CT及MRI表现及其临床意义,尤其是MRI表现国内相关报道较少,旨在为国内学者今后进行相关领域更深入的临床研究提供思路和参考。
文摘目的：探讨轴位腰椎小关节和椎间盘M R T2＊mapping成像的可行性，明确T2＊mapping定量成像技术对小关节和椎间盘早期退变的评估价值。方法收集慢性下腰痛患者22名作为病例组，性别和年龄匹配的健康志愿者20名为正常对照组，采用3．0T M RI对两组行T2＊mapping及常规T2 WI成像，根据Weishaupt分级法、Pfirrmann分级法分别对L2～ S1各节段小关节和椎间盘进行形态学分级，并测量小关节和椎间盘的 T2＊值，进行对比分析。结果不同Weishaupt分级小关节的T2＊值差异无统计学意义（ P＞0.05）。不同Pfirrmann分级椎间盘髓核的T2＊值差异有统计学意义（ P ＜0．05）。小关节与后纤维环的T 2＊值呈弱相关性（ r‐0．3874）。病例组与对照组小关节的 T 2＊值很相近，而髓核的T2＊值差异有统计学意义（ P ＜0．05）。在小关节评价的组间一致性方面，T2＊值的一致性很好（ r ＝0．835，P ＜0.05）；形态学Weishaupt分级一致性较差（kappa＝0．327）。结论此研究表明T2＊ mapping可用于软骨的定量研究，且轴位的腰椎小关节和椎间盘T2＊mapping联合成像是可行的。
文摘Spinal pain(SP)is a common condition that has a major negative impact on a patient’s quality of life.Recent developments in ultrasound-guided injections for the treatment of SP are increasingly being used in clinical practice.This clinical expert consensus describes the purpose,significance,implementation methods,indications,contraindications,and techniques of ultrasound-guided injections.This consensus offers a practical reference point for physicians to implement successfully ultrasound-guided injections in the treatment of chronic SP.
文摘Objective： To explore the patterns of innervation of cervical facet joints and determine the pathways from facet joints to dorsal root ganglions （DRGs） in order to clarify the causes of diffuse neck pain, headache, and shoulder pain. Methods： Forty-two male Sprague-Dawley rats, weighing 250-300 g, were randomly divided into three groups： Group A （ n = 18） , Group B （ n = 18） , and Group C （ n = 6 ）. Under anesthesia with intraperitoneal pentobarbital sodium （45 mg/kg body weight）, a midline dorsal longitudinal incision was made over the cervical spine to expose the left cervical facet joint capsule of all the rats under a microscope. The rats in Group A underwent sympathectomy, but the rats in Group B and Group C did not undergo sympathectomy. Then 0.6 μl 5 % bisbenzimide （Bb） were injected into the C1-2, C3-4 and C5-6 facet joints of 6 rats respectively in Group A and Group B. The holes were immediately sealed with mineral wax to prevent leakage of Bb and the fascia and skin were closed. But in Group C, 0.9% normal saline was injected into the corresponding joint capsules. Then under deep reanesthesia with intraperitoneal pentobarbital sodium （45 mg/kg body weight）, C1 -C8 left DRGs in all rats and the sympathetic ganglions in Group B were obtained and the number of the labeled neurons was determined. Results ： Neurons labeled with Bb were present in C1- C8 DRGs in both Group A and Group B, and sympathetic ganglions in Group B. In the C1-2 and C3-4 subgroups, labeled neurons were present from C1to C8 DRGs, while in C5-6 subgroups they were from C3 to C8. The number of Bb （＋） neurons after sympathectomy was not significantly different in the injected level from that without sympathectomy. But in the other levels, the number of Bb （ ＋ ） neurons after sympathectomy was significantly less than that without sympathectomy. Conclusions： The innervation of the cervical facet joints is derived from both sensory and sympathetic nervous system, and DRGs are associated
