Dullerud R, Nakstad P H
Department of Radiology, Ullevaal University Hospital, Oslo, Norway.
Acta Radiol. 1994 Sep;35(5):415-9.
In order to assess changes occurring to lumbar disk herniations and bulges and to the disk spaces after conservative treatment, a follow-up CT was carried out of 106 pathologic disks in 92 patients at a mean interval of 14 months after the initial examination. There was a strong association between the evolution of the hernias and clinical results, with a decrease in size of the majority of hernias in successfully treated patients, whereas the others essentially remained unchanged (p < 0.0001). A significantly higher proportion of large hernias diminished as compared to the smaller ones (p < 0.0001). Diffuse disk bulges were associated with a poor outcome and never regressed. There was a lower incidence of diminution of the central hernias compared to other locations. Patients with normal disk space at the initial examination had a better outcome than those with disk space narrowing. Only occasionally was a reduction of the disk space observed at follow-up.
为了评估保守治疗后腰椎间盘突出症、膨出及椎间盘间隙的变化，对92例患者的106个病变椎间盘进行了随访CT检查，平均随访时间为初次检查后14个月。疝的演变与临床结果之间存在密切关联，成功治疗的患者中大多数疝的大小减小，而其他患者基本保持不变（p<0.0001）。与较小的疝相比，较大的疝缩小的比例明显更高（p<0.0001）。弥漫性椎间盘膨出与预后不良相关，且从不消退。中央疝缩小的发生率低于其他部位。初次检查时椎间盘间隙正常的患者比椎间盘间隙变窄的患者预后更好。随访时仅偶尔观察到椎间盘间隙减小。
