Fagerlund M K, Thelander U, Friberg S
Department of Diagnostic Radiology, University Hospital, Umeå, Sweden.
Acta Radiol. 1990 Nov;31(6):555-8.
The change in the relative size of lumbar disc hernias and its relation to sciatic symptoms was investigated in 30 consecutive patients after conservative treatment of CT verified lumbar disc herniations. CT and clinical examination were performed before the start of therapy (CT1), as well as 3 months (CT2) and 24 months (CT3) after institution of treatment. In each patient the size of the lumbar disc herniation in relation to the size of the spinal canal was measured on identical CT slices and expressed as an index. The disc herniation index decreased markedly from CT1 to CT2 (p less than 0.001). Between CT2 and CT3 the reduction of the hernias was less pronounced and not significant for hernias located centrally but still significant for intermediate (p = 0.03) and lateral (p = 0.04) hernias. The degree of sciatic symptoms also decreased markedly between CT1 and CT2 (p = 0.001) while no further improvement occurred from CT2 to CT3. There was a significant positive correlation between the improvement from sciatic pain and the reduction in the size of the individual hernia (CT1-CT2 p = 0.02, CT2-CT3 p less than 0.001). Thus, the disc herniation index provided a method to study the anatomic effect of conservative treatment as well as a method to evaluate sciatic symptoms in relation to anatomic changes.
对30例经CT证实的腰椎间盘突出症患者进行保守治疗后，研究了腰椎间盘突出症相对大小的变化及其与坐骨神经症状的关系。在治疗开始前（CT1）、治疗开始后3个月（CT2）和24个月（CT3）进行CT和临床检查。在每例患者中，在相同的CT切片上测量腰椎间盘突出症相对于椎管大小的尺寸，并表示为一个指数。椎间盘突出症指数从CT1到CT2显著下降（p<0.001）。在CT2和CT3之间，中央型椎间盘突出症的缩小不太明显且无统计学意义，但中间型（p = 0.03）和外侧型（p = 0.04）椎间盘突出症仍有统计学意义。坐骨神经症状的程度在CT1和CT2之间也显著下降（p = 0.001），而从CT2到CT3没有进一步改善。坐骨神经痛的改善与单个椎间盘突出症大小的缩小之间存在显著正相关（CT1-CT2 p = 0.02，CT2-CT3 p<0.001）。因此，椎间盘突出症指数提供了一种研究保守治疗解剖学效果的方法，以及一种评估与解剖学变化相关的坐骨神经症状的方法。
