突出髓核对神经根挤压作用的临床意义--71例腰椎间盘突出症患者CT(MRI)轴位像分析

目的：观察突出髓核与关节突关节及椎板（黄韧带）的挤压作用对椎管内神经根的影响，并探讨其临床意义。方法：以CT或MRI轴位像为依据，将71例（男45例，女26例；年龄13～59岁，平均37．5岁）腰椎间盘突出症患者按照突出髓核和关节突关节或（和）椎板（黄韧带）间距大小分为3型，测量椎间盘矢状径指数（SI）、患侧直腿抬高角度。观察SI值、间距分组与患侧直腿抬高角度的相关性。结果：患者年龄、性别、SI与患侧直腿抬高角度无关（P〉0．05），间距分组与患侧直腿抬高角度呈负相关（r=-0．8787，P〈0．01）：结论：突出髓核与关节突关节及椎板（黄韧带）等对神经根的挤压作用反映了神经根的受压程度。

Clinical meaning of the surrounding compression on the nerve root by the protruded nucleus pulposus and facet or lamina(ligamentum flavum):analysis of CT(MRI) axial slice images of 71 patients with lumbar disc herniation

Objective: To observe the pinching action to the nerve root by the lumbar disc herniation and facet or lamina (ligamentum flavum) and evaluate its clinical meaning. Methods: Seventy-one patients were divided into 3 groups according to the size of distance between protrusion of nuclear and facet or lamina(ligamentum flavum). The degree of the straight leg raising of the affected side(SLR) and the sagittal index(SI)of lumbar disk herniation were measured and analyzed among them. Results: There was no corelation between the affected degree of SLR and sex,age and SI of patient(P >0.05). The coefficient between distance group and the affected degree of SLR is-0.878 7(P <0.01). Conclusion: The degree of the surrounding compression by the protrusion of nuclear and facet or lamina(ligamentum flavum) reflects the injuried severity of the nerve root.