小儿腰椎间盘突出症  

Lumbar Disc Herniation in Children

作　　者：万树斌[1] 张质彬[1] 张学军[1] 

机构地区：[1]天津医院小儿骨科,300211

出　　处：《中华小儿外科杂志》1999年第4期215-217,共3页Chinese Journal of Pediatric Surgery

摘　　要：目的　对小儿腰椎间盘突出症的病因、症状与体征进行总结, 以提高其诊治水平。方法　对1990 ～1997 年收治的14 例小儿腰椎间盘突出症资料进行总结, 男9 例, 女5 例。年龄6 ～14岁,10 岁以上13 例。该病以外伤或重复性创伤为其原因。临床表现为腰痛伴有下肢放射性疼痛,直腿抬高阳性, 部分患儿患肢腱反射减弱或皮肤感觉减退。X 线平片检查显示脊柱侧凸, 腰椎生理前突消失, 相应椎间隙后侧增宽。CT 扫描和MRI检查可明确显示腰椎间盘突出范围及马尾神经和/或神经根受压程度。12 例采用保守治疗,2 例手术。结果　小儿腰椎间盘突出症愈后良好, 即使存在有神经受压状况, 非手术治疗仍可获得满意效果。结论　结合小儿腰椎间盘突出症的临床表现和体征, 加之影像学检查, 诊断并非困难, 保守治疗效果好。Objective To review our experience of managing lumbar disc herniation in children. Methods Between 1990 and 1997, 14 children, 9 boys and 5 girls, with lumbar disc herniation were admitted. The age ranged from 6 to 14 years, with 93% of them above the age of 10. The causes included trauma and repetitive stress. Patients presented with lower back pain with radiation to the legs, positive straight leg raising sign, diminished tendon reflexes and sensation. X ray showed scoliosis, absence of phy siological lordosis and widening of intervertebral space. Disc herniation and compression of spinal and/or nerve root could be demonstrated on CT or MRI. Twelve children were managed conservatively where 2 children underwent operation. Results The overall prognosis of lumbar disc herniation in children was good, despite nerve root compression. Conservative management was satisfactory. Conclusions Combination of clinical presentation and imaging studies facilitate the diagnosis of lumbar disk herniation in children. Conservative management is satisfactory. Discoidectomy and decompression are indicated in the inefficient cases.

关 键 词：腰椎 椎间盘突出 儿童 诊断 治疗 X线 CT 

分 类 号：R726.815.3[医药卫生—儿科] R816.8[医药卫生—临床医学]