直腿抬高手法治疗腰椎间盘突出症与影像学区域定位的相关性分析  

A Relevant Analysis of the Treatment of Prolapsed Lumbar Intervertebral Disc and the Imaging Study of Its Three dimensional Localization with the Method of Straight Leg Raising

作　　者：王希[1] 

机构地区：[1]湖北省中医药研究院骨伤科研究所,湖北武汉430074

出　　处：《中国中医骨伤科杂志》2001年第1期23-25,共3页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：湖北省科学技术厅重点项目 !编号 :2 0 0 0 2 12

摘　　要：目的 :探讨直腿抬高手法治疗腰椎间盘突出症的适应症 ,以及影响疗效的相关因素。方法 :采用胡有谷的影像学区域定位法分类 ,回顾性地分析 12 0例腰椎间盘突出症的治疗效果。结果 :椎间盘突出所在的层、区及域 ,治愈率和有效率分别为 91.7%、92 .6 %、80 .8% ,无效率分别为 8.3%、7.4 %、19.2 %。合并侧隐窝狭窄、椎管狭窄影像学征者共 76例、占 6 3.3% ,治愈率和有效率分别为 86 %、84 .2 % ,无效率为 14 %、15.8%。结论 :突出在 c～ d域 ,超过了椎管前后径的 1/ 2 ,为巨大型椎间盘突出 ,应持谨慎态度 ,不宜首选直腿抬高手法治疗。对影像学提示有侧隐窝狭窄和椎管狭窄的病例 ,应考虑其实际病理的多样性和复杂性 ,应具有相应的临床症状 ,以“症”的判断为重点。合并侧隐窝狭窄症和椎管狭窄症是影响疗效的相关因素。Objective:Probing into the method of straight leg raising treating prolapsed lumbar intervertebral disc adaptive symptom and impacting curative effect relevant factor.Methods:Adopting the classification of three dimensional localization imaging study by Hu Yuogu,we retrospectively analyse curative effect of 120 cases of prolapsed lumbar intervertebral disc.Results:Prolapsed lumbar intervertebral disc locating at layer,section,field,the cure rates and efficiency rates were 91.7%,92.6%,80.8%,the failed rates were 8.3%,7.4%,19.2%.Coalescing side crypta stenosis and spinal stenosis patients were 76 cases(accounting for 63.3%).The cure rates and efficiency rates were 86%,84.2%;the failedrates were 14%,15.8%.Conclusion:The prolapse locating at c～d field,excess 1/2 of vertebral canal fore and aft diameter,was called largeness type prolapsed lumber intervertebral disc.This case should be held cautions attitude and was inadvisable to choose the method of straight leg raising as premier choice.The cases of side crypta stenosis and spinal stenosis having clue to imaging study,should consider its actual pathologic diversity and complexity.This case had reciprocal clinical symptom,and judged by symptom as emphases.Coalescing side crpta stenosis and spinal stenosis are relevant factor of affecting curative effect.

关 键 词：腰椎间盘突出 直腿抬高手法 CT 影像学区域定位 

分 类 号：R274.915.3[医药卫生—中西医结合] R244[医药卫生—中医骨伤科学]