极外侧型腰椎间盘突出症磁共振分级与下腰痛评分的相关性  

The correlation between MRI grading and lower back pain score in far lateral lumbar disc herniation

作　　者：王晓明[1] 王生伟[1] 陈丽娟[1] 贾永庚[1] 万玉珍[1] 

机构地区：[1]甘肃省酒泉市人民医院放射科,735000

出　　处：《中国临床研究》2014年第7期778-781,共4页Chinese Journal of Clinical Research

基　　金：甘肃省酒泉市科技项目(2010J248 R2)

摘　　要：目的探讨磁共振(MRI)分级与下腰痛评分的相关性及其在诊断极外侧型腰椎间盘突出症(Far lateral lumbar disc herniation,FLLDH)中的价值。方法回顾性分析2009年8月至2014年4月收治的经手术确诊的35例FLLDH患者的MRI表现,并选择同时期其他类型的腰椎间盘突出症(LDH)包括中央型、侧后型共35例作为对照组,根据其突出间盘大小及与神经根受累情况进行MRI分级,并分析MRI分级与各自下腰痛评分[采用日本骨科学会(JOA)腰痛评分]的相关性。MRI分级评分越高表示突出间盘越大及神经根受累情况越严重;下腰痛评分越低表示功能障碍越明显。结果 (1)MRI下,FLLDH与其他类型LDH分布节段差异有统计学意义(P<0.05),FLLDH多见于L3~L4、L4~L5节段,而L5~S1无FLLDH分布。(2)FLLDH的MRI分级高于其他类型LDH(t=5.714,P<0.01),下腰痛评分低于其他类型LDH(t=4.406,P<0.01),两组间差异均有统计学意义。(3)FLLDH的MRI分级与下腰痛评分呈负相关关系(r=-0.754,P<0.05)。结论 MRI的FLLDH分级评分与神经根受压引起的下腰痛虽然有一定的相关性,但在临床应用中还应注意其他影响因素。Objective To investigate the correlation between magnetic resonance imaging （MRI） grading and lower back pain score and its diagnostic value for far lateral lumbar disc herniation （FLLDH）. Methods The appearances of MRI in 35 cases of FLLDH confirmed by operation between August 2009 and April 2014 were analyzed retrospectively. Thirty-five patients with other types of lumbar disc herniation （LDH） including central type and lateral-back type at same time were selected as control group. MRI grading was conducted according to size of lumbar intervertebral disc of protrusion and affected situation of nerve root. The correlation between MRI grading and corresponding back pain score according to the standard of Japanese Orthopaedic Society （JOA） was analyzed. The higher MRI grading score meaned the bigger lumbar disc size of protrusion and the more serious nerve root involvement; the lower back pain score meaned the more obvious dysfunction. Results MRI showed that there was obvious difference in distribution segment between FLLDH and other types of LDH （P 〈 0.05 ）. FLLDH was more seen in L3-L4, and L4-L5, while L^-S1 had no-distribution. The MRI grading score of FLLDH was significantly higher than that of other types of LDH （t =5. 714,P 〈0.01 ） ,and the lower back pain score of FLLDH was significantly lower than that of other types of LDH （ t = 4. 406, P 〈 0.01 ）. The MRI grading score of FLLDH was negatively correlated with lower back pain score （ r = - 0. 754, P 〈 0. 05 ）. Conclusions Although there is a certain relationship between the FLLDH grading score of MRI and lower back pain caused by nerve root compression, other influencing factors should still be paid attention to in the clinical application.

关 键 词：腰椎间盘突出症 极外侧型 磁共振成像 下腰痛 

分 类 号：R445.2[医药卫生—影像医学与核医学] R681.5[医药卫生—诊断学]