Yu Qing-yang, Yang Cun-rui, Yu Lang-tao
Department of Orthopaedics and Traninatology, the TCM Hospital of Longyan, Longyan 364000, Fujian, China.
Zhongguo Gu Shang. 2009 Apr;22(4):279-82.
Using regional assignment to forked method to study lumbar intervertebral disc hemiation (bugle, hernia, prolapse) dependablity and reason of lumbar intervertebral disc herniation and asymptomatic lumbar intervertebral disc herniation.
From March 2005 to October 2006, 120 patients of match condition from orthopaedics dept and rehabilitative dept of the Boai hospital of Longyan were studied. All patients were equally divided into two groups according to whether or not accompany with symptom of lumbar intervertebral disc herniation. There was not statistical difference in sex, age, course of disease, segment of intervertebral disc between two groups. Sixty patients of symptomatic lumbar intervertebral disc herniation were equally divided into three groups according to (bugle, hernia, prolapse) image on CT. Sixty patients of asymptomatic lumbar intervertebral disc herniation were equally divided into three groups according to (bugle, hernia, prolapse) image on CT. The age was 20-59 years old with an average of 38.5 years. Using regional assignment to give a mark respectively for every group. The sagittal diameter index (SI), anterior diastema of flaval ligaments, the width of superior outlet of latero-crypt, anteroposterior diameter of dura sac were respectively measured by sliding caliper. CT value and protrusible areas were respectively evaluated by computer tomography. Adopting mean value to measure three times.
(1) There were not statistical difference in SI, CT value, hernia areas, anteroposterior diameter of dura sac between two groups (symptomatic lumbar intervertebral disc herniation and asymptomatic lumbar intervertebral disc herniation). There were statistical difference in the width of superior outlet of latero-crypt, anterior diastema of flaval ligaments between two groups (symptomatic lumbar intervertebral disc herniation and asymptomatic lumbar intervertebral disc herniation). (2) There were statistical difference in protrusible type,protrusible segment between two groups (symptomatic lumbar intervertebral disc herniation and asymptomatic lumbar intervertebral disc herniation).
There were not necessary relationship between in protrusible size, location, type, compression degree and clinical symptom. This paper may support the mechanism of lumbar intervertebral dise herniation that associated with the following the three aspects: (1) spinal reserve capacity (SRC); (2) involved nerve roots escaping from herniated disc compression and its elastic lengthening function; (3) hypoxia symptosis and anti-ischemia injury compensation of involved nerve roots.
采用区域划分叉形法研究腰椎间盘突出症(膨出、疝出、脱出)与无症状腰椎间盘突出症的可靠性及腰椎间盘突出症的原因。
选取2005年3月至2006年10月龙岩市博爱医院骨科和康复科符合条件的120例患者。所有患者根据是否伴有腰椎间盘突出症症状分为两组。两组在性别、年龄、病程、椎间盘节段方面无统计学差异。60例有症状的腰椎间盘突出症患者根据CT上的(膨出、疝出、脱出)影像分为三组。60例无症状的腰椎间盘突出症患者根据CT上的(膨出、疝出、脱出)影像分为三组。年龄为20 - 59岁,平均38.5岁。采用区域划分法分别对每组进行标记。用游标卡尺分别测量矢状径指数(SI)、黄韧带前间隙、侧隐窝上出口宽度、硬脊膜囊前后径。通过计算机断层扫描分别评估CT值和突出面积。采用平均值测量三次。
(1)有症状的腰椎间盘突出症组与无症状的腰椎间盘突出症组在SI、CT值、疝出面积、硬脊膜囊前后径方面无统计学差异。两组在侧隐窝上出口宽度、黄韧带前间隙方面有统计学差异。(2)有症状的腰椎间盘突出症组与无症状的腰椎间盘突出症组在突出类型、突出节段方面有统计学差异。
突出大小、位置、类型、压迫程度与临床症状之间无必然联系。本文可能支持腰椎间盘突出症的机制与以下三个方面有关:(1)脊髓储备能力(SRC);(2)受累神经根从突出椎间盘压迫中逃逸及其弹性延长功能;(3)受累神经根的缺氧症状及抗缺血损伤代偿。