腰椎间盘突出症的纵向位移分型的初步探讨

目的探讨腰椎间盘突出症纵向位移分型的的临床特点与意义。方法回顾性分析2008年6月~2011年2月120例单纯腰椎间盘突出症﹙L3~S1﹚患者,参考目前腰椎间盘突出症传统分型及临床影像学资料进行纵向定位分型,并比较不同分型患者的临床症状体征、疗效。结果经12周以上随访,术后3种分型组患者的术后临床症状均明显缓解,JOA分值显著增加,ODI指数明显下降;但通过不同分型患者之间的对比分析发现椎间盘突出头移型患者的术后临床疗效最差,有显著的统计学意义﹙<0.01﹚。结论腰椎间盘突出症患者纵向定位的3种分型具有临床特异性,应针对不同的分型采用不同方式的手术治疗,传统椎板间开窗术式对于椎间盘突出头移型患者的临床疗效欠佳。

A preliminary discuss of the Classify of longitudinal displacement in Protrusion of Lumbar Intervertebral Disc

Objective To investigate the clinical characteristics and importance of classification of longitudinal displace- ment of lumbar disc herniation. Method A retrospective analysis of 120 cases of single lumbar disc herniation （ L3-S1 ） patients, with referenco to the current traditional classification of lumbar disc herniation and clinical imaging data for longitudinal positioning type, then compare with different classifications＇ patients clinical symptoms and effectiveness. Results After 12 weeks follow-up, the clinical symptom of 3 classification groups patients were significantly alleviated, the JOA score increased significantly while the ODI index decreased significantly; but among 3 groups of patients, the group of displacement toward head got the worst postoperative effects, and there is significant statistical significance （ P 〈 0.01） Conclusion The patients with longitudinal displacement of lumbar disc herniation of the three types have a cli- nical specificity, they should be used different ways＇ operation treatment, traditional surgical methods for longitudinal displacement of lumbar disc herniation patients don＇t have enough clinical efficacy.