Bergaoui N, Ladeb F, Ben Hammouda M, Gannouni A, Essgaier K, Guefrech I, Mourad A, Elmay M
Service de Médecine Interne, Faculté de Médecine de Monastir, Tunisie.
Rev Rhum Mal Osteoartic. 1992 Jul-Sep;59(7-8):478-81.
In a patient with disk herniation it is often difficult to establish that the disk is free in the spinal canal. A retrospective medical record study comparing 65 cases of free herniated disk (FHD) confirmed upon surgery and 65 cases of disk protrusion (DP) demonstrated that FHD was more common in young male blue collar workers, especially those who worked in the sitting position. No clinical findings were diagnostic of FHD although the straight-leg raising test was positive at smaller angles than in disk protrusion. In this study, sensitivity and specificity of CT scan for the diagnosis of FHD were 75% and 80%, respectively. CT scan findings suggestive of FHD included a free disk fragment, found in 22.5% of cases, and an acute connecting angle. Saccoradiculography was more sensitive but less specific than CT scan in this study. In FDH, migration was common and ragged hernia contours were seen on the saccoradiculography images.
在椎间盘突出症患者中，通常很难确定椎间盘在椎管内是否游离。一项回顾性病历研究比较了65例经手术证实为游离性椎间盘突出（FHD）的病例和65例椎间盘膨出（DP）的病例，结果表明FHD在年轻男性蓝领工人中更为常见，尤其是那些从事坐姿工作的人。尽管直腿抬高试验在比椎间盘膨出更小的角度呈阳性，但没有临床发现可诊断为FHD。在本研究中，CT扫描诊断FHD的敏感性和特异性分别为75%和80%。提示FHD的CT扫描结果包括22.5%的病例中发现的游离椎间盘碎片和急性连接角。在本研究中，脊髓造影比CT扫描更敏感但特异性更低。在FDH中，移位很常见，脊髓造影图像上可见不规则的疝轮廓。
