腰椎间盘膨出症的诊断与治疗(附82例CT分析)  

The diagnosis and treatment of lumbar intervertebral disk prominence

作　　者：崇步伟 周永春 王通新 刘振华 

机构地区：[1]中国煤矿工人临沂温泉疗养院

出　　处：《中医正骨》1997年第3期13-14,共2页The Journal of Traditional Chinese Orthopedics and Traumatology

摘　　要：报告了８２例腰椎间盘膨出症，对其ＣＴ检查结果和临床表现进行了分析。认为该病的发病原因主要是在生理性退变的基础上，遭受外伤和慢性劳损等诱因，造成纤维环内层纤维断裂，使其局部或整体向周围膨隆，压迫或刺激局部神经或血管组织而产生临床症状的。其病理变化是椎间盘变性的一种早期征象，可以成为椎间盘突出的病理基础。临床常规查体和Ｘ线难以与腰椎间盘突出症相鉴别，诊断名称常被其替代，确诊要靠ＣＴ等特征性影像学检查。ＣＴ诊断分为弥漫性和局限性膨出两大类，局限性膨出又可分为若干型。临床治疗原则以保守治疗为主，采用瞬间成角旋转牵引配合手法治疗能够取得满意疗效。Eighty two cases of lumbar intervertebral disk prominence (LIDP)are reported in this paper.Through analysing the clinical manifestations and CT scannings,it was suggested that the main pathogenetic cause of the disease is the fracture of the inner layer fibres in the fibrous ring, which is caused by injury and strain and othes inductors based on the physiologic degenerative changes. The inner layer fibres fracture causes the peripheral bulge of the partial or total out layer fibres,which compresses and irritates the local nerves and blood vessels and thus produces the clinical symptoms.The pathological changes are an early sign of the degeneration of the intervertebral disk and may become the pathological basis for lumbar intervertebral disk hernia(LIDH).It is difficult to differentiate LIDP from LIDH by the routine clinical physical examinations and X ray films. In diagnostic nomenclature,the former is often replaced with the altter and can be diagnosed only by the special image examinations like CT,etc.According to CT diagnosis,LIDP can be diveded into localized and diffused types,and the localized could in turn be subyrouped into several types. The conservative treatment is taken as the main therapeutic principle,and instant angulation rotation traction traction and manipulations couldobtain satisfactory therapeutic effects.

关 键 词：腰椎 椎间盘膨出症 放射照相术 CT 分型 治疗 

分 类 号：R681.53[医药卫生—骨科学]