腰痛的诊疗和鉴别诊疗培训课件.ppt

1、今天讲授特点：提问式今天讲授特点：提问式腰痛的诊疗和鉴别诊疗10/21/20221天生我材必有天生我材必有 痛！痛！腰痛的诊疗和鉴别诊疗10/21/20222腰痛的诊疗和鉴别诊疗10/21/20223腰痛的诊疗和鉴别诊疗10/21/20224腰痛的诊疗和鉴别诊疗10/21/20225腰痛的诊疗和鉴别诊疗10/21/20226腰痛的诊疗和鉴别诊疗10/21/20227腰痛的诊疗和鉴别诊疗10/21/20228腰痛的诊疗和鉴别诊疗10/21/20229腰痛的诊疗和鉴别诊疗10/21/202210腰痛的诊疗和鉴别诊疗10/21/202211腰痛的诊疗和鉴别诊疗10/21/202212腰痛的诊疗和鉴别

2、诊疗10/21/202213腰痛的诊疗和鉴别诊疗10/21/202214腰痛的诊疗和鉴别诊疗10/21/202215腰痛的诊疗和鉴别诊疗10/21/202216腰痛的诊疗和鉴别诊疗10/21/202217腰痛的诊疗和鉴别诊疗10/21/202218腰痛的诊疗和鉴别诊疗10/21/202219腰痛的诊疗和鉴别诊疗10/21/202220腰痛的诊疗和鉴别诊疗10/21/202221腰痛的诊疗和鉴别诊疗10/21/202222腰痛的诊疗和鉴别诊疗10/21/202223腰痛的诊疗和鉴别诊疗10/21/202224腰痛的诊疗和鉴别诊疗10/21/202225腰痛的诊疗和鉴别诊疗10/21/202226

3、腰痛的诊疗和鉴别诊疗10/21/202227腰痛的诊疗和鉴别诊疗10/21/202228腰痛的诊疗和鉴别诊疗10/21/202229腰痛的诊疗和鉴别诊疗10/21/202230腰痛的诊疗和鉴别诊疗10/21/202231腰痛的诊疗和鉴别诊疗10/21/202232腰痛的诊疗和鉴别诊疗10/21/202233腰痛的诊疗和鉴别诊疗10/21/202234腰痛的诊疗和鉴别诊疗10/21/202235腰痛的诊疗和鉴别诊疗10/21/202236腰痛的诊疗和鉴别诊疗10/21/202237腰痛的诊疗和鉴别诊疗10/21/202238腰痛的诊疗和鉴别诊疗10/21/202239腰痛的诊疗和鉴别诊疗10/2

4、1/202240 正常正常 峡部骨折峡部骨折 峡部不连峡部不连 脊柱滑脱脊柱滑脱腰痛的诊疗和鉴别诊疗10/21/202241腰痛的诊疗和鉴别诊疗10/21/202242腰痛的诊疗和鉴别诊疗10/21/202243腰痛的诊疗和鉴别诊疗10/21/202244腰痛的诊疗和鉴别诊疗10/21/202245腰痛的诊疗和鉴别诊疗10/21/202246腰痛的诊疗和鉴别诊疗10/21/202247腰痛的诊疗和鉴别诊疗10/21/202248腰痛的诊疗和鉴别诊疗10/21/202249腰痛的诊疗和鉴别诊疗10/21/202250腰痛的诊疗和鉴别诊疗10/21/202251腰痛的诊疗和鉴别诊疗10/21/20

5、2252腰痛的诊疗和鉴别诊疗10/21/202253 侧位 正位L5S1峡部裂腰痛的诊疗和鉴别诊疗10/21/202254L5S1峡部裂滑脱腰痛的诊疗和鉴别诊疗10/21/202255斜位片，图中箭头处为峡部裂斜位片，图中箭头处为峡部裂狗颈征图示狗颈征图示狗嘴表示同侧横突，狗眼狗嘴表示同侧横突，狗眼表示椎弓根，狗耳为上关节突，狗颈为表示椎弓根，狗耳为上关节突，狗颈为峡部，狗体为椎板，前后狗腿表示同侧峡部，狗体为椎板，前后狗腿表示同侧与对侧之上下关节突，狗尾为对侧横突与对侧之上下关节突，狗尾为对侧横突 腰痛的诊疗和鉴别诊疗10/21/202256腰痛的诊疗和鉴别诊疗10/21/202257腰痛的

6、诊疗和鉴别诊疗10/21/202258腰痛的诊疗和鉴别诊疗10/21/202259腰痛的诊疗和鉴别诊疗10/21/202260腰痛的诊疗和鉴别诊疗10/21/202261椎体下关节突椎板上关节突椎弓根椎体椎孔椎板椎弓根腰痛的诊疗和鉴别诊疗10/21/202262小关节椎间孔椎弓根黄韧带椎板椎体后方椎间盘椎弓根后纵韧带椎弓根椎间孔硬膜囊神经根腰痛的诊疗和鉴别诊疗10/21/202263退变性混合性腰痛的诊疗和鉴别诊疗10/21/202264腰痛的诊疗和鉴别诊疗10/21/202265腰痛的诊疗和鉴别诊疗10/21/202266主要临床表现主要临床表现腰痛的诊疗和鉴别诊疗10/21/202267腰

7、痛的诊疗和鉴别诊疗10/21/202268腰痛的诊疗和鉴别诊疗10/21/202269腰痛的诊疗和鉴别诊疗10/21/202270腰痛的诊疗和鉴别诊疗10/21/202271腰痛的诊疗和鉴别诊疗10/21/202272腰痛的诊疗和鉴别诊疗10/21/202273腰痛的诊疗和鉴别诊疗10/21/202274脊椎指数：脊椎指数：椎体横、矢径椎体横、矢径乘积与椎管横、矢径乘积乘积与椎管横、矢径乘积之比大于之比大于4.5，应考虑椎管，应考虑椎管狭窄。狭窄。腰痛的诊疗和鉴别诊疗10/21/202275腰痛的诊疗和鉴别诊疗10/21/202276C T 扫 描临 床 符 合 率 极 高横 径 小 于 1

8、3 m m矢 径 小 于 1 0 m m神经根管口小于3mm腰痛的诊疗和鉴别诊疗10/21/202277腰痛的诊疗和鉴别诊疗10/21/202278腰痛的诊疗和鉴别诊疗10/21/202279腰痛的诊疗和鉴别诊疗10/21/202280腰痛的诊疗和鉴别诊疗10/21/202281腰痛的诊疗和鉴别诊疗10/21/202282腰痛的诊疗和鉴别诊疗10/21/202283腰痛的诊疗和鉴别诊疗10/21/202284腰痛的诊疗和鉴别诊疗10/21/202285腰痛的诊疗和鉴别诊疗10/21/202286腰痛的诊疗和鉴别诊疗10/21/202287腰痛的诊疗和鉴别诊疗10/21/202288腰痛的诊疗和

9、鉴别诊疗10/21/202289腰痛的诊疗和鉴别诊疗10/21/202290腰痛的诊疗和鉴别诊疗10/21/202291腰痛的诊疗和鉴别诊疗10/21/202292腰痛的诊疗和鉴别诊疗10/21/202293腰痛的诊疗和鉴别诊疗10/21/202294腰痛的诊疗和鉴别诊疗10/21/202295腰痛的诊疗和鉴别诊疗10/21/202296腰痛的诊疗和鉴别诊疗10/21/202297腰痛的诊疗和鉴别诊疗10/21/202298腰痛的诊疗和鉴别诊疗10/21/202299腰痛的诊疗和鉴别诊疗10/21/2022100腰痛的诊疗和鉴别诊疗10/21/2022101腰痛的诊疗和鉴别诊疗10/21/20

10、22102腰痛的诊疗和鉴别诊疗10/21/2022103腰痛的诊疗和鉴别诊疗10/21/2022104腰痛的诊疗和鉴别诊疗10/21/2022105腰痛的诊疗和鉴别诊疗10/21/2022106腰痛的诊疗和鉴别诊疗10/21/2022107腰痛的诊疗和鉴别诊疗10/21/2022108腰痛的诊疗和鉴别诊疗10/21/2022109腰痛的诊疗和鉴别诊疗10/21/2022110腰痛的诊疗和鉴别诊疗10/21/2022111腰痛的诊疗和鉴别诊疗10/21/2022112腰痛的诊疗和鉴别诊疗10/21/2022113腰痛的诊疗和鉴别诊疗10/21/2022114腰痛的诊疗和鉴别诊疗10/21/202

11、2115腰痛的诊疗和鉴别诊疗10/21/2022116腰痛的诊疗和鉴别诊疗10/21/2022117腰痛的诊疗和鉴别诊疗10/21/2022118腰痛的诊疗和鉴别诊疗10/21/2022119腰痛的诊疗和鉴别诊疗10/21/2022120腰痛的诊疗和鉴别诊疗10/21/2022121腰痛的诊疗和鉴别诊疗10/21/2022122腰痛的诊疗和鉴别诊疗10/21/2022123腰痛的诊疗和鉴别诊疗10/21/2022124腰痛的诊疗和鉴别诊疗10/21/2022125腰痛的诊疗和鉴别诊疗10/21/2022126腰痛的诊疗和鉴别诊疗10/21/2022127腰痛的诊疗和鉴别诊疗10/21/2022128腰痛的诊疗和鉴别诊疗10/21/2022129腰痛的诊疗和鉴别诊疗10/21/2022130腰痛的诊疗和鉴别诊疗10/21/2022131腰痛的诊疗和鉴别诊疗10/21/2022132