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作 者:陈伟南[1] 刘富华[1] 朱建平[1] 骆宇春[1] 蔡福金[1] 汪建良[1]
出 处:《实用骨科杂志》2001年第6期407-410,共4页Journal of Practical Orthopaedics
摘 要:目的:探讨腰椎间盘突出症症状体征、影像学检查与手术定位的关系。方法:把腰椎间盘突出症症状体征分成三类,回顾性地统计分析了187例单一间隙腰椎间盘突出手术病人的分类症状体征及影像学情况,寻找定位诊断的规律。结果:下肢放射痛、旁侧压痛、股神经牵拉试验、跟腱膝腱反射、足底感觉异常具有明显的定位意义,而直腿抬高试验、伸肌力减退在L4~4和L5~S1易相混淆。出现2个以上分类症状体征要素的机率L3~4为80%,L4~5为97%,L5~S1为99%,影像学诊断阳性率为97.3%(182/187),假阳性率为18.7%(35/187)。结论:对某一腰椎间盘突出症的定位诊断,如果有两个以上的分类症状体征要素出现,同时有影像学的突出,定位诊断即告成立。Objective: To discuss the relationship between the symptoms of lumbar disc herniation,radiology and opera- tive position. Methods:The symptoms and physical signs of lumbar disc herniation were classified into 3 groups. The symptoms,physical signs and radiology of 187 operated patients of single herniated lumbar disc.Results: The were analysed retrospectively to find out the regular of location diaghoss radiaring pain of lower limbs,latera1 tenderhess, thigh nerve tension test,achilles's tendon reflex,knee tendon reflex and paresthesia in p1anta pedis were more impor- tant for diagnosis. But straight leg raising test and weakness of the extensor digitorum longus were hot exact in L4~5 or L5~S1. The probabilities of L3~4,L4~5and L5~S1 which possess two c1assified symptoms were 80%,97% and 99% respectively. Positive rate of radiological diagnosis was 97. 3% (182/187 ),pseudo positive rate was 18. 7 % (35/ 187). Conclution: The location diagnosis of sigle lumbar disc herniation needs more than two classified symptoms and physical signs appeared,and radiological confirmation at the same time.
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