CT诊断腰椎间盘突出症合并椎管狭窄的临床价值

Computerized Tomography in Diagnosis of Herniated Lumbar Intervertebral Disc Complicating Spinal Stenosis

腰椎间盘突出症120例,经CT诊断并手术证实合并椎管狭窄者23例,术中证实黄韧带肥厚1例,共24例,占20%。术前不遗漏腰椎管狭窄,术中在摘除突出之椎间盘同时对合并的椎管狭窄作彻底减压,对提高疗效至关重要。24例随访,8个月至4年,手术优良率为91.6%,CT检查可以对腰椎间盘突出合并椎管狭窄作出诊断与手术符合率为95.8%,对疑有椎管狭窄者特别是高龄、病程长和症状不典型者尤需行CT检查。

This is an analysis of 24 cases among 120 cases with herniated lumbar intervertebral disc in the past 5 years.All the 24 cases complicated spinal stenosis and were followed up for an average of 23 months(8 months to 4 years),good result was obtained in 91.6%.It is the most important point of elevating clinical therapeutical effect after lumbar intervertebral disc sur- gery that the spinal stenosis should not be overlooked during the examina- tion before operation.Diagnosis of herniated lumbar intervertebral disc com- plicating spinal stenosis can be made by CT scanning.The accuracy of the diagnosis was much higher than that of other examining methods.In this paper,the coincidence rate of diagnostic results of CT scanning and operation was 95.8%,so the authors believe that it is necessary to have CT scanning for herniated lumbar intervertebral disc in doubt of complicating spinal stenosis,particularly for herniated intervertebral disc of senile patients,or the patients with long course of disease and absence of char- acteristic symptoms.