척추 전방전위증의 전산화 단층촬영 소견 : 협부형과 퇴행형의 비교

CT Study of Spondylolisthesis Comparison Between Isthmic and Degenerative Type

  • 이종덕 (원광대학교 한의과대학 진단방사선과) ;
  • 변재영 (원광대학교 한의과대학 광주한방병원 침구과)
  • Lee, Jong-Deok (Department of Diagnostic Radiology, College of Oriental Medical, Won Kwang University) ;
  • Byun, Jae-Young (Department of Acupuncture & Moxibustion, Kwang Ju Oriental Medical Hospital, College of Oriental Medical, Won Kwang University)
  • 투고 : 2000.10.30
  • 심사 : 2000.11.13
  • 발행 : 2000.12.20

초록

Objectives : To evaluate the findings useful for differential diagnosis and associated abnormaiities of isthmic spondylolisthesis and degenerative spondylolisthesis on CT. Materials and methods : We reviewed retrospectively the CT images of 65 patients who were diagnosed spondylolisthesis during 3 years period. Our technique was 5mm slices at 5mm intervals with gantry angle to parallel the interspaces. Also reformatted sagittal views were taken. 41 patients were isthmic spondylolisthesis and 24 patients were degenerative spondylolisthesis. Resuits : Isthmic spondylolisthesis. 1. Isthmic type was more common at L5-S1. 2. The degree of anterior displacement was grade I and II. 3. The plane of defect was more horizontal than the usual facet joint. 4. The defect had an irregular shape. 5. Medial aspect of bone just anterior to defect had a small round prominence. 6. Anteroposterior elongation of the spinal canal was common. 7. Pseudobulging disk was common. 8. The most common associated abnormality was a HNP at the upper level of the defect. Degenerative spondylolisthesis. 1. Degenerative type was more common at L4-5. 2. The degree of anterior disptacement was grade I and II. 3. The Plane of facet joint was oriented obliquely instead of horizontally. 4. The posterior facet(inferior facet of superior vertebra) was anteriorly displaced. 5. Bony spur of the posterior portion of anterior facet was seen. 6. The facet joints often contain gas(vaccum phenomenum). 7. The most common associated abnormality was a HNP at the level of the displacement. Conclusions : CT is a highly accurate and most sensitive technique for recognition, differential diagnosis of isthmic and degenerative types and the detection of associated abnormalities.

키워드

참고문헌

  1. Cited in Clin Radiol v.20 spondylolysteses gravissimae causa nuper detecta.In. Commentatio anatomica obstetrica. Bonnae lit. C. Geirgii, 1854 Kilian, H.F.
  2. J Bone Joint Surg(Am) v.23 low backache and sciatic pain associated with spondylolisthesis and protruded intervertebral disc. Meyerding, H.W.
  3. Clin. Orthop. v.117 Classification of Spondylolysis and Spondylolisthesis Wiltse, L.L.;Newman, P.H.;Macnab, I.
  4. J Comput Assist Tomogr v.9 Computed tomography of spondylolisthesis: patterns of associated pathology Elster, A.D.;Jensen, K.M.
  5. CT of the lumbar spine Degenerative spondylolisthesis Sheldon, J.J.;Lebargne, J.M.;Post, J.D.(ed)
  6. Instructional course lectures v.32 Degenerative spondylolisthesis Brown, M.D.;Lockwood, J.M.;Evarts, C.M.(ed.)
  7. The Spine Lumbar spondylolisthesis Epstein, B.S.
  8. Backache Spondylolisthesis Macnab, I.
  9. The spine(3rd ed.) Spondylolisthesis Amundson, G.;Edwards, C.C.;Garfin, S.R.;Rothman, R.H.;Simeone, F.A.(eds.)
  10. Neurological surgery(3rd ed.) v.4 Spondylolisthesis and spondylolysis McPhee, B.;Youmans, J.R.(ed)
  11. Campbell's operative orthopaedics(8th ed) v.5 Other disorders of the spine Wood, G.W.;Crenshaw, A.H.(ed)
  12. J comput Assit Tomogr v.9 incomplete ring sing ; A simple method for CT detection of spndylolysis Langston, J.W.;Gavant, M.L.
  13. Neurological surgery(3rd ed) v.4 Spondylolisthesis and spondylolysis McPhee, B.;Youmans, J.R.(ed)
  14. AJNR. v.5 CT muItiplanar reconstruction in 253 cases of lumbar spondylolisthesis (case report) Rothman, SLG;Glenn, W.V. Jr.
  15. CT of the lumbar spine Spondylolysis and spondylolisthesis Rothman, SLG;Glenn, W.V. Jr.;Post, J.D.(ed)
  16. CT of the spine and spinal canal Spondylolysis and spondylolisthesis Rothman, SLG;Glenn, W.V. Jr.;Newton, T.H.;Dotts, D.G.(eds.)