腰椎间盘突出症CT分型与硬膜外注射术疗效分析.pdfVIP

· 818· 中国骨伤2007年l2月第2O卷第l2期 China J Orthop＆Tmuma．Dec．2007．Vo1．20．No．12 · I临．eK~JI究 · 腰椎间盘突出症CT分型与硬膜外注射术 疗效分析 刘昱彰，周卫，张世民 (中国中医科学院望京医院脊柱一科，北京 100102) 【摘要】 目的：探讨硬膜外注射术治疗腰椎间盘突出症的适应证，以及不同CT分型患者的疗效差异。方法：采 用胡有谷的影像学区域定位法分类，回顾性分析195例腰椎间盘突出症患者的治疗效果，其中男99例，女96例；年龄 22～74岁。主要症状：腰痛，单侧下肢或双下肢的放射痛及皮肤痛觉减退，间歇性跛行等，均采用硬膜外注射术治疗。 结果：疗效评定根据MacNab改良标准，突出物位于I层、1区、2区、1—2区及a域，优良率分别为95．4％、92．6％、 90．0％、84．3％、94．4％，疗效优于其他区域，差异有统计学意义。结论：硬膜外注射术是治疗腰椎间盘突出症的较好 方法，而对于按胡有谷的CT区域定位法分类，突出物位于I层、1区、2区、1—2区及a域的患者疗效更佳。 【关键词】 椎间盘移位；腰椎； 注射，硬膜外 Relationship between CT classification of lumbar disk herniation and therapeutic effects of epidural injection HU Yu—zhang，ZHOU Wei，ZHANG Shi—min．The First Department ofSpine，Wangfing Hospital ofChina Academy ofChinese Medical Science，Beijing 100102，China ABSTRACT 0bjective：To explore the indication of epidural injection for the treatment of lumbar disk herniation，and to find relationship between its therapeutic effects and the CT classification．Methods：Among 195 patients reviewed in the study， 99 patients were male and 96 patients were female，ranging in age from 22 to 74 years．The lumbar disc herniation of the pa- tients were classified according to imaging regional location method defined by HU You—gu．The main symptoms included low back pain，radiating pain of single or double lower limb，skin hypoalgesia or intermittent limping．All the patients were treated with epidural injection．Results：According to modified Macnab criteria，prolapsed lumbar intervertebral discs were located at I layer，1 section，2 section，1 to 2 section and a field．The excellent and good rates of the above region were 95．4％，92．6％， 90．0％，84．3％，94．4％respectively，and the results had statistical differences．Conclusion：Epidural injection is a good meth— od for the treatment of lumbar disc herniation．If the prolapsed lumbar intervertebral discs are located at I layer。1 se