影像学检查在腰椎间盘突出症伤病关系法医学鉴定中的应用

Application of Imaging in Protrusion of Lumbar Intervertebral Disc Injury Relationship in Medicolegal Expertise

摘要: 目的：研究探讨法医鉴定中如何利用影像学分析判定椎间盘病变与外伤之间的因果关系。方法：对双滦司法鉴定中心2006年6月至2014年5月78例腰椎间盘突出症的年龄、病变类型及临床特点进行分析。结果：椎间盘病变与本次外伤有关的22例(28.2%)，其中椎间盘突出18例，椎间盘膨出基础上发生突出的4例；椎间盘病变与本次外伤无关56例(71.8%)，其中椎间盘膨出24，椎间盘突出32例。结论：鉴定时应充分考虑伤者的年龄、职业，特别是椎体、关节、韧带有无退行性变，并根据外力的大小，结合影像学表现认真分析损伤和疾病在损害后果中的作用程度。

Abstract: Objective: It studies how to use image analysis to determine the causal relationship between the lesions of intervertebral disc and trauma in forensic identification. Methods: It analyzes the age, pathological types and clinical characteristics of 78 cases of lumbar disc herniation from June 2006 to May 2014 in Forensic Medical Identification Center. Results: There are 22 cases of the in-tervertebral disc diseases associated with the trauma (28.2%), including 18 cases of lumbar disc herniation, 4 cases of intervertebral disc protrusion on the basis of prominent; in 56 cases of in-tervertebral disclesions unrelated with the trauma (71.8%), 24 are disc bulging, and 32 are pro-trusion of the intervertebral disc. Conclusion: when we identify, we should consider the age of the wounded, occupation, especially whether there is retrogression in the ligament, vertebral joints. According to the magnitude of the external force, combined with image, we have to analyze function degree of serious injury and disease in the consequences of the damage.