摘要： 目的 分析直立位X线对腰椎滑脱的诊断效能。方法 纳入2020年1-10月经首都医科大学宣武医院综合判断确诊的60例腰椎滑脱患者，收集其直立位X线和仰卧位CT矢状位重建资料，采用Marique.Taillard法于X线和CT图像后处理工作站测量腰椎相对滑脱距离（dd'）、下椎体上缘长度（cd），并计算滑脱度以及不同体位下主观阅片腰椎滑脱检出率。结果 与仰卧位CT矢状位重建参数相比，直立位X线所显示的dd'值（Z=5.918，P=0.000）、cd值（Z=4.082，P=0.000）和滑脱度（Z=6.064，P=0.000）增加；且腰椎滑脱检出率为95%（57/60），高于仰卧位CT矢状位重建的81.67%（49/60，P=0.039）。结论 腰椎直立位X线可增加腰椎应力，有益于反映滑脱椎体在日常应力情况下的滑脱度，提高腰椎滑脱检出率，若与仰卧位CT矢状位重建联合诊断，可为临床提供更详尽的影像学资料，并辅助制定具有针对性的治疗方案。

关键词: 脊椎滑脱, 腰椎, 体层摄影术, X线, 体层摄影术, 螺旋计算机

Abstract: Objective To analyze the diagnostic efficacy of orthostatic X-ray radiography in lumbar spondylolisthesis. Methods Sixty patients with lumbar spondylolisthesis diagnosed by Xuanwu Hospital of Capital Medical University from January to October 2020 were included. The orthostatic X-ray and supine CT sagittal reconstruction imaging data were collected, and the Marique. Taillard method was used to measure the relative spondylolisthesis distance (dd') and the length of the upper edge of the inferior vertebral body (cd) on the X - ray and CT image post - processing workstation. Finally, the degree of spondylolisthesis and the detection rate of lumbar spondylolisthesis based on the subjective readings of doctors in different body positions were calculated. Results Compared with the supine CT sagittal reconstruction parameters, the dd' value (Z = 5.918,P = 0.000), cd value (Z = 4.082,P = 0.000) and spondylolisthesis (Z = 6.064,P = 0.000) were significantly improved. The positive rate of lumbar spondylolisthesis was 95% (57/60), which was higher than 81.67% (49/60,P = 0.039) of the supine CT sagittal reconstruction. Conclusions Orthostatic X-ray radiography can increase the lumbar vertebra stress of patients, which is beneficial to reflect the degree of spondylolisthesis of vertebra under daily stress conditions and improve the positive rate of lumbar spondylolisthesis. If combined with supine CT sagittal reconstruction, it can be used for clinical diagnosis and provide more detailed imaging data to assist in formulating targeted surgical treatment plans.

Key words: Spondylolysis, Lumbar vertebrae, Tomography, X - ray, Tomography, spiral computed