腰痛症患者における腰椎MRI画像所見の検討

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  • The relationship between the magnetic resonance imaging of the lumbar spine and lowback pain
  • ヨウツウショウ カンジャ ニ オケル ヨウツイ MRI ガゾウ ショケン ノ ケントウ

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(目的) MRlは腰痛をきたす疾患の診断に必須な検査法である｡腰痛と腰椎MRl所見との関係を明らかにすることを目的として検討した｡(対象と方法)腰痛を訴えた30例を対象とし､腰椎MRl所見の頻度を調査した｡全例に温泉療法を施行した｡　 (結果)全症例において腰椎MRl上異常所見を認めた｡少なくとも1つ以上の椎間板の変性病変をもつ症例は30例中27例(90% )で､椎間板変性はL4/5levelで最も多く認められた(30例中18例)｡椎間板ヘルニア を示す症例は30例中10例(33.3% )であった｡神経根圧迫を持つ症例は30例中8例(26.7% )であった｡腰椎圧迫骨折を持つ症例は30例中6例(20% )であった｡温泉療法により腰痛が改善した症例は30例中17例(56.7% )であった｡　 (結論)腰痛症患者は腰椎MR止異常所見を有した｡温泉療法により腰痛の改善を認めたので､MRL上で認めた形態学的異常は必ずしも機能的異常や症状に直結しないと思われた｡

(Purpose) Magnetic resonance imaging (MRI) is essential to diagnosis of diseases which happen low back pain. The purpose of this study was to investigate the relationship between low back pain and the characteristics on MRI scans of the lumbar spine. (Materials and Methods) We performed MRI examinations of lumbar spine in 30 patients with low back pain and examined the prevalence of abnormal findings on MRI scans of the lumbar spine in 30 patients with low back pain. (Results) Overall in present study, all patients with low back pain had abnormalities around the lumbar spines on MRI. Disc degeneration was present in one or more lumbar levels in 27 (90% ) of all the subjects. The disc degeneration was most commonly observed at U/LS, where 18 (60% ) of all the subjects displayed evidence of disc degeneration. Disc herniation was found in 10 (33.3% ) of all the subjects. Nerve root compression at one level or more was observed in 8 (26.7% ) of the subjects. Compression fracture at one level or more was observed in 6 (20% ) of all the subjects. Spa therapy improved low back pain in 17 (56. 7% ) of the subjects. (Conclusion) All patients with low back pain had abnormalities around the lumbar spines on MRI. Because spa therapy improved low back pain, morphological abnormalities on MRI scans don't always connect with functional abnormalities and symptoms.

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