胸腰段椎间盘突出症临床特点研究

目的 研究各节段胸腰段椎间盘突出症临床表现的特点.方法 回顾性分析我院自2000 年4 月-2011 年1 月手术治疗单节段胸腰段(T10-L3) 椎间盘突出59 例,其中T10-T11 组5 例,T11-T12 组19 例,T12-L1 组12 例,L1-L2 组13 例,L2-L3 组10 例.结果 各个节段中常见的临床症状依次为根性放射痛(44/59,74.6%),行走障碍(40/59,67.8%),下肢麻木(37/59,62.7%) 下肢无力(35/59,59.3%) 腰背痛(29/59,49.2%) ;T10-T11 组和T11-T12 组以下肢麻木无力表现为主,主要表现上运动神经元损伤的体征;T12-L1 组多伴有腹股沟区域感觉平面(6/12,50.0%) 和鞍区感觉障碍(4/12,33.3%),以下运动神经元损害和混合型损害体征为主;L1-L2 组和L2-L3 组表现为神经根症状,累及范围主要在大腿前外侧,主要表现为下运动神经元损伤体征.不同节段腰背痛发生率比较有统计学差异(P<0.05),下位节段腰背痛发生率高于上位节段.结论 T10-T11 组和T11-T12 组表现为上神经元受损,T12-L1 组表现为明显感觉平面和广泛下肢力弱,L1-L2 组和L2-L3组表现根性感觉和运动障碍.

Clinical characteristics of thoracolumbar intervertebral disc protrusion

Objective To study the clinical characteristics of thoracolumbar intervertebral disc protrusion.Methods Clinical characteristics of 59 patients with thoracolumbar intervertebral disc protrusion(T10-L3) undergone operation in our hospital from April 2000 to January 2011 were retrospectively analyzed.The patients were divided into T10-T11 group(n=5),T11-T12 group(n=19),T12-L1 group(n=12),L1-L2 group(n=13) and L2-L3 group(n=10).Results Radiating pain,ambulation disability,numbness and weakness of lower extremity,and back pain occurred in 44,40,37,35 and 29 of the 59 patients respectively,with an incidence of 74.6%,67.8%,62.7%,59.3% and 49.2%,respectively.The main symptoms of T10-T11 and T11-T12 groups were numbness and weakness of lower extremity manifested as injury of upper motor neurons.Sensory disturbance was found in groin and saddle regions of T12-L1 group,manifested as lower motor neuron injury and mixed injury,with an incidence of 50.0% and 33.3%,respectively.The radiculopathy and sensory distrubance mainly involving the anterolateral leg in L1-L2 and L2-L3 groups were manifested as injury of lower motor neurons.The incidence of back pain was significantly different in different groups(P<0.05),and much higher in the lower groups than that in the upper ones.Conclusion Upper neuron injury occurs in T10-T11 and T11-T12 groups,sensory disturbance and weakness of lower extremity occur in T12-L1 group,sensory disturbance and dyscinesia of nerve roots occur in L1-L2 and L2-L3 groups.