腰骶神经根综合征患者的症状性和无症状性异常：临床检查与磁共振成像的比较
Symptomatic and asymptomatic abnormalities in patients with lumbosacral radicular syndrome: Clinical examination compared with MRI.
作者信息
van Rijn Jeroen C, Klemetso N, Reitsma J B, Majoie C B L M, Hulsmans F J, Peul W C, Bossuyt P M, Heeten G J den, Stam J
机构信息
Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, Room J1B-210, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
出版信息
Clin Neurol Neurosurg. 2006 Sep;108(6):553-7. doi: 10.1016/j.clineuro.2005.10.003. Epub 2005 Nov 10.
OBJECTIVE
To determine the frequency of symptomatic and asymptomatic herniated discs and root compression in patients with lumbosacral radicular syndrome (LRS) and to correlate clinical localization with MRI findings.
METHODS
Fifty-seven patients with unilateral LRS were included in the study. Using the visual analogue scale, two physicians independently localized the most likely lumbar level of complaints. These clinical predictions of localizations were correlated with the MRI findings.
RESULTS
MRI showed abnormalities on the symptomatic side in 42 of 57 patients (74%). In 30% of the patients, MRI confirmed an abnormality at the exact same level as determined after clinical examination. On the asymptomatic side, MRI showed abnormalities in 19 of 57 patients (33%), 13 (23%) of these patients had asymptomatic root compression.
CONCLUSIONS
In more than two-thirds of the patients with unilateral LRS there was no exact match between the level predicted by clinical examination and MRI findings. These discrepancies complicate the decision whether or not to operate.
目的
确定腰骶神经根综合征（LRS）患者中症状性和无症状性椎间盘突出及神经根受压的发生率，并将临床定位与磁共振成像（MRI）结果相关联。
方法
57例单侧LRS患者纳入本研究。两名医生使用视觉模拟量表独立确定最可能的腰部主诉节段。这些临床定位预测与MRI结果相关联。
结果
57例患者中有42例（74%）MRI显示症状侧有异常。30%的患者中，MRI证实异常节段与临床检查后确定的节段完全相同。在无症状侧，57例患者中有19例（33%）MRI显示异常，其中13例（23%）患者有无症状性神经根受压。
结论
在超过三分之二的单侧LRS患者中，临床检查预测的节段与MRI结果并不完全匹配。这些差异使手术决策变得复杂。
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