破裂型腰椎间盘突出症的临床特点与影像学诊断

目的:探讨破裂型腰椎间盘突出症的临床特点及影像学诊断。方法:收集资料完整的128例腰椎间盘突出症患者,手术证实为破裂型者48例,对患者临床症状、体征、数字X射线摄影(DR)、CT及MRI特点进行分析。结果:破裂型腰椎间盘突出症81.25%有咳嗽时腰腿痛加重,87.50%出现短暂腰痛加重后有明显腿痛,直腿抬高试验<40°;DR腰椎前凸及腰椎生理曲度异常62.4%,椎间隙异常83.2%,CT显示边缘模糊,髓核异位,巨大突出及后缘锐角征象,其CT髓核突出率常超过50%;MRI显示脱出髓核周围低信号带亦有较高发生率,髓核脱出率在50%以上,MRI可见椎体后方低信号条状影中断。结论:破裂型腰椎间盘突出症具有症状明显、神经损害重等特点,结合影像学检查征象有助于提高破裂型腰椎间盘突出症。

Clinical and Radiological Characteristics of Noncontained Lumbar Disc Herniation

Objective To study the clinical and radiological characteristics of noncontained lumbar disc herniation.Methods We retrospectively reviewed the medical records of 128 patients with lumbar disc herniation who underwent surgery and evaluated the characteristics of clinical signs and symptoms,CT and MRI of noncontained lumbar disc herniation.Results In 128 patients,48 had noncontained lumbar disc herniation.In these 44 patients,80% had aggravated lumbar and leg pain when coughing;86% had intensive leg pain after transient aggravated lumbar pain;the result of the straight leg raising test was patients.In these patients,the rate of disc herniation was more than in CT,and focal interruption of the black line was found in MRI.Conclusion We can establish the diagnosis of noncontained lumbar disc herniation before operation basing on the characteristics of clinical signs and symptoms and manifestation of CT and MRI.