摘要
目的探讨破裂型腰椎间盘突出症患者首选保守治疗方法的临床疗效及影像学变化。方法将2008-06-2014-06期间首选保守治疗的89例破裂型腰椎间盘突出症患者进行分析研究,统计其最终手术率、临床疗效,并根据MR图像计算突出物体积及吸收率。结果 89例患者中,72例经保守治疗病情得到缓解或治愈,17例最终接受手术治疗,手术率19.10%。保守治疗的患者治疗后3个月、6个月、1年JOA评分优良率分别为80.56%、83.33%、83.33%,JOA评分与治疗前比较,差别均有显著统计学意义(P<0.01)。保守治疗患者中,15例发生明显重吸收(RR>50%),占总人数的16.9%。结论破裂型腰椎间盘突出症大部分通过保守治疗症状可得到缓解,一部分可出现突出物重吸收现象。
Objective To explore the clinical and radiographic outcomes of posterior longitu- dinal ligament （PLL） ruptured lumbar disc heruiation（LDH） via conservative treatment as a pre- ferred solution. Methods From June 2008 to June 2014, 89 cases of ruptured LDH initially received conservative treatment were studied. The JOA score was used to evaluate efficacy, the volume and resorption rate of the herniation were calculated according to MR image. Results （1） Among the 89 cases,72 patients were relieved or cured,only 17 patients ultimately received operation. The ratio of operation was 19.10%. （2）The excellent and good rates were 80.56%, 83.33% and 83.33% at the end of the 3rd, 6th month and the 1st year after conservative treatment. Significant differences of JOA scores were found between each time points and the time before treatment（P〈0.01）.（3） In the patients who accepted non-operative therapy： 15 cases （16.9%） were found that the herniation obviously resorbed （RR〉50%）,the excellent and good rate of efficacy was 100% at the 1-year follow-up. The other 57 cases were partly or no re- sorption（RR~.〈50%）, the excellent and good rate of efficacy of the 57 cases was 80.70%. There was no significant difference of the excellent and good rate between the obviously resorption and partly or no resorption（P=0.105）. Conclusion The ruptured LDH is not the indication of oper- ation. After conservative treatment,symptoms of most patients can be relieved and some of them can be found the phenomenon of herniation resorption by MRI. If the conservative treatment was invalid or the symptoms grow progressively or appeared cauda equina syndrome,operation must be done as soon as possible.
出处
《颈腰痛杂志》
2015年第6期475-478,共4页
The Journal of Cervicodynia and Lumbodynia
基金
国家自然科学基金资助编号:81473691
江苏省中医药局资助:NO.LZ13148
关键词
腰椎
椎间盘移位
后纵韧带
重吸收
lumbar vertebra
intervertebral resorption. disc displacement
posterior longitudinal ligament
resorption.
