腰椎间盘突出与下腰痛的关系  

Relation between protrusion of columbar intervertebar and lower lumbar pain syndromes

作　　者：黄振强 罗玉琛 

机构地区：[1]广东省湛江市中心人民医院骨二科,湛江524037

出　　处：《海南医学》2003年第8期12-13,共2页Hainan Medical Journal

摘　　要：目的 探讨腰椎间盘突出与下腰痛的关系。方法 回顾分析518例腰椎间突出症在局麻下摘除椎间盘术的麻醉范围及手术效果。结果 所有患者在局麻下切除黄韧带、后纵韧带,松解黄韧带与硬膜囊间的粘连,咬除椎间盘时无疼痛出现。作神经根封闭前刺激神经根及封闭神经根时出现强烈的放射性下肢痛,却无腰痛发生。术后所有患者的放射性下肢痛消失或明显减轻,却有小部份患者的腰痛未能缓解。结论 窦椎神经末梢对机械压迫不敏感。腰椎间盘突出引起窦椎神经末梢及小关节的炎性反应,使其敏感性增高以及加重腰椎不稳是腰椎间盘突出引起下腰痛的主要原因。Objective To discuss the relation between protrusion of columbar intervertebar and lower lumbar pain syn-dromes. Methods the anaesthesia scope and surgical operation result were analvzed retrospective!y for 518 case of patients whose protrusions were removed in local anaesthesia. Result All the patients had no pain when cutting ligamenta flava and posterior longitudinal lig, releasing the adhesion between ligamenta flava and spinal dura matter, removing intervertebral disc in local anaesthesia. and they had strong radioactive melosalgia but no lower lumbar pain syndromes when touching the nerve roots before or just as giving them block anaesthesia. To all the patients, the melosalgia disappeared after the operation, but few of the them stili has lower lumbar pain syndromes. Condusions The nerve periphery is not resposive to com-pression. protrusion of columbar intervertebar causes the inflammatory reaction of the nerve periphery and zygapophysical joints and makes the backbone more amphibolic is the main reason that cause the lower lumbar pain syndromes.

关 键 词：腰椎间盘突出 下腰痛 椎间盘摘除术 麻醉范围 手术效果 

分 类 号：R681.53[医药卫生—骨科学]