髓核突出类型与腰腿痛严重程度的关系(附300例分析)

RELATION OF SEVERITY OF LOW BACK PAIN TO TYPE OF PROLAPSED INTERVERTEBRAL DISC

试验观察了不同类型的髓核突出与患者腰腿痛严重程度的关系。本组300例患者均经手术确诊为腰椎间盘突出症,术前患者疼痛按严重程度分5级。术中观察并记录髓核突出的类型及其与神经根的关系,并与术前患者的症状、体征作对照。病变的髓核分以下4种类型:膨出型85例,突出型104例,脱出型72例。游离型39例。结果表明,腰椎间盘突出病人的腰腿痛程度与髓核突出的类型有关。椎管内组织的炎症是造成严重腰腿痛的重要因素。

In this study the relation between the extent and type of disc protrusion and the clinical severity of symptoms of low back pain was observed. Our series consisted of 300 consecutive cases of lumbar disc protrusion,with their diagnosis confirmed by intraoperative observation. Preoperative pain severity was assessed using a back pain scale that combined the symptoms of back pain and sciatica. Intraoperaative pathological findings of disc were documented and comparesd with preoperative symptoms and signs. The pathological changes of disc were classified as following four subtypes: bulging disc (85 cases), protruding disc (104 cases), extruded disc (72 cases) and sequestered disc (39 cases). Our results suggest that severity of pain in patients with herniated lumbar disc is related to position of herniation rather than magnitude and exent of herniation. Inflammed intraspinal tissues are significantly associated with low back pain and sciatica.