医学
椎管狭窄
腰椎
体格检查
椎管
放射科
脊髓造影
磁共振成像
孔
椎管狭窄
椎间孔
病史
侧隐窝
神经系统检查
外科
腰痛
狭窄
脊髓
替代医学
病理
精神科
作者
Takao Yasuhara,Susumu Sasada,Isao Date
出处
期刊:PubMed
[National Institutes of Health]
日期:2021-11-01
卷期号:49 (6): 1233-1245
被引量:4
标识
DOI:10.11477/mf.1436204510
摘要
Accurate diagnosis is important for lumbar degenerative diseases. Patients' history, neurological examination, and diagnostic imaging are the three pillars for accurate diagnosis. While collecting medical history, 5W1H of the symptoms should be considered. Muscle strength, pain and numbness, and deep tendon reflex are the basic parameters in the neurological examination. A combination of the results of each tool is needed to facilitate precise diagnosis. This should be followed by diagnostic imaging to confirm the diagnosis. We feel relieved when neurological examination and diagnostic imaging reveals congruent results. The symptoms of lumbar degenerative diseases are the results of[static factors: the stenosis of the canal/intervertebral foramen]×[dynamic factor: the instability]. The T2-weighted MRI images effectively reveal canal/intervertebral foramen stenosis. Short-T1 inversion recovery(STIR)of MRI reveals early fractures and inflammation of the spine. CT findings help to imagine the process of drilling and screw insertion. A whole spine X-ray is good to reveal spinal alignment. Roentogenkymography with anteflexion/retroflexion reveals the instability of the lumbar spine. Myelography is effective in knowing the cerebrospinal fluid flow in a standing position. Therefore, accurate diagnosis and careful treatment are needed to obtain the appropriate outcome for a prolonged period after spinal surgery.
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