摘要
目的通过自动经皮椎间盘切吸术(APLD)临床疗效与腰椎管脊髓造影(Dynemicmyel-ography,DM)影像的分析,探讨腰椎后纵韧带在腰椎间盘突出时的作用以及与手术适应症的选择。方法临床诊断腰椎间盘突出患者行腰椎管脊髓造影,分别测量病变椎间隙在侧卧过伸位、过屈位硬膜囊受压深度,过伸位减过屈位数值,我们称之为弹性指数,以此判断腰椎后纵韧带弹性大小和椎间盘纤维环的完整性。设定为:弹性指数值≥0.5cm为弹性好,0.5-0.3cm为弹性较好,<0.3cm为弹性差。统计分析106例APLD患者临床效果。结果APLD术后51例显效,41例有效,14例无效,分析弹性指数与效果的相关性,各组之间有统计学意义。结论腰椎后纵韧带对椎间盘突出髓核有动力源性的还纳作用。其弹性作用在腰椎间盘突出症行椎间盘切吸术疗效中起重要作用,通过DM对其弹性指数分析,可以作为椎间盘突出症患者实行APLD手术的适应症之一。
Objective To investigate the effect of lumbar vertebae posterior longitudial ligament in protrusion of lumbar intervertebral disc and importance of clinical effect when used in APLD in order to aisess the indication. Methods Clinical diagnosis of 106 protrusion of lumbar intetvertebral disc patients by lumbar spinal dynamic myelography（DM）,then measured the pressure depth of spinal dura and judged the elasticity of the lumbar vertebae posterior longitudial ligament and the intergrality of the spinal discs fibrering. What we called elasticity index was defined as follows：the value of elasticity index was more than or equal to 0.5cm being considered as good elasticity,between 0.5cm and 0.3cm was considered as comparatively good elasticity,less than 0.3cm was considered as bad elasticity. According to it APLD was performed on 106 patients and analyzed clinical situation before and after operation. Results After treatment 51 cases were cured. Clinical symptoms disappeared and recovered,41 cases were of effect in symptom. 14 cases remained inefficient without improvement of clinical symptoms. In accordance with classified data of elasticity index statistical meaning existed between each group. Conclusion Lumbar vertebae posterior longitudial ligament has action of motive power in nucleus pulposus restored of protrusion of intervertebral disc. Its elasticity plays an important part in curative effect of APLD for protrusion of lumbar in tetvertebral disc. By analyzing elasticity index we can consider it as one of operative indications that APLD is available to perform a surgical operation on protrusion of lumbar intetvertebral disc.
出处
《颈腰痛杂志》
2007年第5期374-376,共3页
The Journal of Cervicodynia and Lumbodynia
关键词
后纵韧带
椎间盘突出
切吸术
腰椎管动态造影
posterior longitudial ligament
protrusion of lumbar intetvertebral disc
APLD
lumbar spinal dynamic myelography
