腰椎管内突出髓核的临床意义探讨──附44例腰椎间盘突出症患者与73例正常人CT资料的三维分析

目的：探讨突出髓核组织在椎管内空间占位的临床意义。方法：４４例腰椎间盘突出症患者（Ａ组）及７３例正常人（Ｂ组，其中２２例有腰椎间盘突出者为Ｂ１组，余为Ｂ２组）观察：（１）突出椎间盘ＣＴ超薄扫描三给数据；（２）腰椎Ｘ线平片及动力学摄片测量数据；（３）分析两组突出髓核组织的体积、表面积、突出髓核椎管内相对占位空间以及腰椎结构和功能等情况的差异和相关性等。结果：正常人群中无症状髓核突出（Ｂ１）者高达３０

Clinical Significance on Protruded Nucleus Pulposus: A Comparative Study of 44 Patients with Lumbar Intervertebral Disc Protrusion and 73 Asymptomatic Control in Tridimentional Computed Tomography

To probe the clinical significance of space occupation of lumbar protruded nucleus pulposus (PNP) in vertebral canal. Methods: Materials of tridimentional ultrathin scanning computed tomography (CT), plain and flexion-extension dynamic radiograph on lumbar spine in 44 patients of lumbar intervertebral disc protrusion and 73 asymptomatic subjects (as control, including 22 cases with PNP but without symptoms) were observed, analysed and compared in volume, surface area, relative space occupation of PNP inside spinal canal, structure deformation and mobility of lumbar spine, and their difference and relevance. Results: The rate of asymptomatic lumbar disc protrusion in the control group was up to 30. 1 %. The volume, surface area and relative space occupation of PNP inside spinal canal in the patients group were significantly higher than those in the control group. Although the structure was more de formed and mobility of lumbar spine more limited in the patients group before and after treatment than those in the control group, as compared with those subjects with asymptomatic PNP, the difference was insignificant. Conclusion: (1)Relative space occupation of PNP inside spinal canal could be usually digested by compensation system of spinal column, however, there is no final conclusion reached about the limit of compensation system; (2) Relatively bigger PNP may reduce the structure compensation capability of lumbar spine, which will result, sometimes, in a mechanical disorder of lumbar spine and nerve root irritation.