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.pdfVIP

16 • 中国骨伤2∞8 年 1 月第 21 卷第 1 期 China J Orthop Trauma ， Jan， 2∞8 ， Vol.21 ,No .l ·开彷论坛· 突出髓核对神经根挤压作用的临床意义 一-71 例腰椎间盘突出症患者 CT(MRI)轴位像分析 冯伟，冯天有，王书勤 (空军总医院中西医结合正骨治疗科，北京 1∞036) I 摘要]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 MRl 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Z巨大小分为 3 型，测量椎间盘矢状径指数(51) 、患侧直腿抬高角 度。观察 51 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、51 与患侧直腿抬高角度元关(P 0， 05) ，间 jg 分组与患侧直腿抬高角度呈负相关(r=-O， 878 7 ,P 0 ,01) c 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。 I 关键词] 腰椎间盘突出症: 突出髓核; 直腿抬高试验 Clinical meaning of the surrounding ωmpression on the nerve root by 伽e protruded nucleus pulposus and facet or lamina (ligamentum Oavum) :analysis of CT (MRI) axial slice images of 71 patients with lumbar disc herniation FENG Wei , FENG Tian -you , WANG Shu -q in, Department of Manipu!aûve Orthopaedics , the Genera1 Hospit a1 of A i矿orce ， Beijing 1∞036 ， China ABSTRACT Objective: To observe the pinching action to the nerve root by the lumbar disc hemìation and facet or lamina Oigamentum f1 avum) and evaluate its clinical meaning , Methods: 5eventy咱ne patients were divided into 3 groups according to the size of distance between protrusion of nuclear and facet or lamina Oigamentum f1 avum) , The deg陀e of the straight leg rais- ing of the affected side (5LR) and the sagìttal ìndex (5I)of lumbar disk hemiation were measured and analyzed among them Results: There was no corelation between the affected degree of 5LR and sex , age and 51 of patient (P 0、 05)、The coefficient between distance group and the affected degree of 5LR is-O、 8787 (P 0, 01) , Conclusion: The degree of the surrounding com- P陀ssìon by the protrusion of nuclear and facet or lamina Oigamentum f1 avum) ref1 ects the injuried severity of the nerve root. Key words Lumbar disc hemiation; Protruded