頸椎椎間盤突出症之核磁共振影像學表現分析

背景：頸椎椎間盤突出症是臨床上常見的脊椎疾病，很多病患是在第一線門診被診斷而後轉介神經外科，骨科或復健科治療。過去對此一疾病單純就影像學上的探討文獻並不多見，因此本研究擬針對其核磁共振影像學(Magnetic Resonance Image, MRI)的表現加以分析，希望能提供臨床診療上之參考。材料與方法：本研究採回溯性研究(retrospective study)，收集對象為2006年1月1日至2006年12月31日於台灣南部某醫學中心接受頸椎核磁共振檢查，來源包括門診、急診或是住院的病患，共680例，以病歷回顧方式，取得個案資料，含年齡、性別，及MRI的檢查報告，經刪除資料不全者，最後有519位頸椎椎間盤突出症病例進入本研究。結果：發現頸椎C5-6為最常見的突出節數，共363例；而突出的方向以中央型最常見，突出型態以椎間盤突出較椎間盤膨出常見，而椎間盤突出者又以突出型較擠出型多，分別為294例及290例；構造上壓迫位置以造成神經孔的狹窄最常見，其次為硬膜囊(thecal sac)的壓迫。519位病例中合併有骨刺的發生率為73.2%，以C5-6最常見，共311例。討論與結論：以往的研究多著重於腰椎椎間盤突出症的探討，對於頸椎椎間盤突出症，則著重於探討結構異常與臨床症狀、危險因子，外科治療適應症及外科手術方法之間的關係，單獨探討影像學上的結構異常，仍屬少數或是已經年代久遠，此研究利用影像學上的發現，和對頸椎椎間盤突出症解剖構造上的認知及定義，不只探討及印證舊有的觀念或共識，另外也更進一步研究結構上的異常，是否在彼此間存有一定的相關性。

關鍵字

頸椎椎間盤突出；頸椎椎間盤膨出；神經孔；硬膜囊

並列摘要

Background: Herniated Cervical Disc, clinically, is a very common spinal disease. Many patients are diagnosed in Family medicine clinic and then transferred to the therapy of Neurosurgery Department, Orthopedic Department or Rehabilitation Department. In Taiwan, based on image study's discussion, there are only a few documents for reference. Therefore, our research focuses on MRI study analysis and hope to provide clinician with some references for diagnosis and therapy. Material and Method: We conducted a retrospective study, collected data from a medical center in southern Taiwan from 2006.1.1 to 2006.12.31. Patients, who received MRI study from outpatient clinic, emergency room, or ward, were included in the study. Result: Among the different level of cervical spine, C5-6 is the most common level. (363 cases). The major herniation direction is central type. As for herniation type, herniation is morecommon than bulging. The former cases have more protrusion than extrusion. Protrusion is 294 cases and extrusion is 290 cases. As for compressed structure, neural foramen is the most common site, and following sac compression. Among 519 cases, we found 73.2% cases combined with the formation of spurs, and C5-6 is the most common level. (311 cases) Conclusion: Previous study about cervical HIVD in Taiwan mainly focus on the discussion of structure, clinical symptom, risk factors or situation of surgical therapy and the relationship with surgery, but lack of study on image presentation. In this study, we demonstrated the various types of MRI image changes; this might help the recognition and definition of cervical disc herniation.

並列關鍵字

cervical disc herniation ； cervical disc bulging ； neural foramen ； sac

國際替代計量

頸椎椎間盤突出症之核磁共振影像學表現分析

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