腰椎间盘突出髓核自发性重吸收的临床分析  

Clinical analysis of spontaneous resorption of lumbar herniated nucleus pulposus:a case series study

作　　者：孟亚轲 潘伟成 乐军[1] 张伟[1] 潘浩[1] 郭永飞 MENG Yake;PAN Weicheng;LE Jun;ZHANG Wei;PAN Hao;GUO Yongfei(Department of Orthopaedics,Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University,Hangzhou 310007,China;Department of Spine Surgery,the Second Affiliated Hospital of Naval Medical University,Shanghai 200003,China)

机构地区：[1]浙江中医药大学附属杭州市中医院骨科,杭州310007 [2]海军军医大学第二附属医院脊柱外科,上海200003

出　　处：《中华骨与关节外科杂志》2025年第4期338-343,共6页Chinese Journal of Bone and Joint Surgery

摘　　要：目的:总结磁共振成像(MRI)显示腰椎间盘突出髓核自发性重吸收(RHNP)的腰椎间盘突出症(LDH)患者的临床特点,以提高临床医师对其的认识。方法:回顾性分析2015年1月至2023年6月于浙江中医药大学附属杭州市中医院因腰腿痛就诊并诊断为LDH、同时发生RHNP的30例患者的影像学资料,包括年龄、性别、RHNP节段、RHNP影像学时间等。结果:本研究30例患者,年龄为23~78岁,平均(44.3±12.6)岁。RHNP节段:L3/43例,L4/58例,L5/S119例。RHNP影像学时间为2~120个月,中位数(四分位数)为31.0(5.8,63.0)个月。3例患者RHNP之后出现局限性高信号区。结论:RHNP可见于各个年龄段的LDH患者,并不局限于年轻患者。临床医师应重视LDH的保守治疗,为RHNP创造一定的时间条件。Objective:To summarize the clinical characteristics of patients with lumbar disc herniation(LDH)who exhibited spontaneous resorption of herniated nucleus pulposus(RHNP)as shown on magnetic resonance imaging(MRI),to enhance clinicians'understanding of this phenomenon.Methods:A retrospective analysis was conducted on the imaging data of 30 patients diagnosed with LDH and experienced spontaneous resorption of RHNP who sought treatment for low back and leg pain at Hangzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University from January 2015 to June 2023.The data included age,sex,vertebral levels of spontaneous resorption of RHNP,and the radiological manifestations of RHNP.Results:A total of 30 patients with an average age of 44.3±12.6 years(range:23-78 years)were included.The vertebral levels of RHNP spontaneous resorption were distributed as follows:3 cases at L3-L4,8 cases at L4-L5,and 19 cases at L5-S1.The MRI-documented spontaneous resorption of RHNP over a period ranging ranged from 2 to 120 months,with the median(quartiles)is 31.0(5.8,63.0)months.Focal high-intensity zones were observed in 3 patients.Conclusions:The spontaneous resorption of RHNP can occur in LDH patients across all age groups and is not limited to younger individuals.Clinicians should emphasize conservative treatment for LDH to allow sufficient time for potential spontaneous resorption of RHNP.

关 键 词：腰椎间盘突出症 髓核 重吸收 

分 类 号：R687.3[医药卫生—骨科学]