外伤性胸椎间盘突出症的早期诊断与手术治疗_临床医学论文.docVIP

外伤性胸椎间盘突出症的早期诊断与手术治疗_临床医学论文 外伤性胸椎间盘突出症的早期诊断与手术治疗_临床医学论文 【摘要】 探讨外伤性胸椎间盘突出症的临床表现、早期诊断及手术治疗效果。［方法］2000年6月～2005年6月共收治外伤性胸椎间盘突出症患者11例，其中男8例，女3例，年龄15～38岁，平均23. 96岁。诊断时间距外伤时间最短的为2 d，最长的8个月，平均4. 1个月。早期明确诊断后行经关节突入路胸椎间盘摘除术。［结果］11例患者获得1. 1～3. 8年术后随访，平均随访2. 6年。根据Otani′s等分级方法进行疗效评价：优7例，良3例，可1例，差0例，失败0例。手术优良率为90. 91％。［结论］外伤性胸椎间盘突出较少见，无典型临床表现，本症的早期诊断及早期手术治疗是远期优良疗效的保证。 【关键词】 外伤； 胸椎 椎间盘移位 早期诊断 手术治疗 Abstract：［Objective］To study the clinical manifestation, early diagnosis and surgical outcomes of traumatic thoracic disc herniation.［Method］Eleven patients of traumatic thoracic disc herniation were selected from June 2000 to June 2005.There were 8 males and 3 females with an average age of 23.96 years old (ranged, 15-38 years old). The average time from traumatism to diagnosis were 4.1 months (range,2 days to 8 months). After early clinical diagnosis,discectomy through posterolateral transpedicular approach were carried out for all 11 patients.［Result］All 11 patients were followed up for an average time of 2.6 years (range,1.1～3.8 years).According to Otanis classification criterion,the results were excellent in 7cases,good in 3 cases, fair in I cases,no poor case and failure case.The excellent and good results were obtained in 90.91% of the patients.［Conclusion］The incidence of traumatic thoracic disc herniation is rather low,and this disease has no representative symptom and sign.Early diagnosis and operative treatment is a very effective guarantee to curative effect for traumatic thoracic disc herniation. Key words：traumatic; thoracic vertebra; intervertebral disk displacement; early diagnosis; surgical treatment 外伤性胸椎间盘突出症是一种少见病。由于本病早期脊髓压迫症状不典型，临床表现缺乏特征性症状体征，往往延误诊断与治疗，最终影响治疗效果，严重危及患者生活质量［1］。本科自2000年6月～2005年6月共收治外伤性胸椎间盘突出症患者11例，随访时间1. 1～3. 8年。本文通过回顾性总结，对该病的诊断特点、手术方法进行探讨。 1 临床资料 本组11例，男8例，女3例，年龄15～38岁，平均23. 96岁，病程最短为2 d，最长8个月，平均4. 1个月。患者具有明确的外伤史，且7例为过屈性损伤。有相关诱因，其中3例为背部被撞击，6例为高处坠落，2例为提携重物所致。11名患者共14节段胸椎间盘突出，其中节段分布为T9、10 1例，T10、11 4例，T11、12 5例，T12L1 4例。本组病人节段分布符合相关文献报道［2］。 2 早期诊断