临床论著·腰椎间盘突出症的分型和其临床意义.PDFVIP

中国骨伤 2000 年 5 月第 13 卷第 5 期 　China J Ort hop Trauma ,May 2000 ,Vol . 13 ,No . 5 ·259 · ·临床论著 · 腰椎间盘突出症的分型及其临床意义 张禄堂 　李星 　张世民　章永东 　周卫 　黎作旭 　刘昱彰 　兰吉瑞 ( 中国中医研究院望京医院 ,北京 100 102) 　　【摘要】　目的　对腰椎间盘突出症就蒋氏分类及其临床意义进行讨论 。方法 　根据腰椎间盘各组 成部分及不同阶段的病理变化 ;从椎间盘到关节突关节 ,从软组织到骨结构 ,从青少年到中老年的病理 特点 ,将椎间盘突出症分为软骨板破裂 、弹力 、退变失稳和增生狭窄四型 。对 396 例不同类型的治疗结 果进行分析 。结果 　从 294 例非手术治疗表明 ,弹力型优良率达 92 65 % ,增生狭窄型为 57 50 % ,两者 ( ) 有显著性差异 P 0 05 。手术治疗 102 例 ,优良率为 92 16 % 。结论 　弹力型大多数可通过非手术达 到满意结果 ,增生狭窄、软骨板破裂晚期以手术治疗为主 。 【关键词】　椎间盘突出 ,腰 　治疗效果 　分类法 The Classif ication into Different Types of Prolapsed Lumbar Intervertebral Disc 　ZHA N G L utang , L I X ing , ZHA N G S him in , et al Wangj ing Hosp ital , China A cademy of Traditional Chinese M edicine ( B ei ) j ing , 100 102 　　【Abstract 】　Objective 　To investigate t he classification into different typ es of prolap sed lumbar inter ventebral disc ( PL ID) and it s clinical significanceMethods 　Based on t he fundamental analysis of t he sp ecial p at hological features of PL ID in t he adolescence ,t he middle aged and t he elderly ,as well as t he structural changes in t he intervertebral disc ,including t he soft and t he osseous tissue ,t he aut hors classified t he lesions of PL ID into four different typ es : 1The ruptured annulous fibrosus typ e2 The elastic protrusion of t he inter vertebral disc3The degenerated and t he unstable PL ID and 4 The hyp ertrop hied lesion wit h spinal steno si sA total of 396 cases of t he different typ es were reviewedResults 　Among t he 294 cases undergone conser vative management ,t he elastic protrution typ e had excellent result s in 92 65 % ,while in t he hyp ertrop hied and t he stenosis group ,t he rate was 57 50 % ,demonstrating a significant diffe