高位腰椎间盘突出症的诊断及治疗

Diagnosis and Surgical Treatment of Upper Lumbar Disc Herniation

目的 探讨高位腰椎间盘突出症的诊断和治疗方法。 方法 综合分析 4 2例高位腰椎间盘突出症患者的临床症状、体征、影像学资料、诊治特点及预后。 结果 4 2例获 1～ 5年随访 ,参照改良的Macnab分级标准评定 ,优 2 5例 (5 9.5 % ) ,良 13例 (31.0 % ) ,可 4例 (9.5 % ) ,优良率达90 .5 %。 结论 临床表现结合MRI和CT检查 ,是诊断高位腰椎间盘突出症的重要手段 ,治疗上主张早期手术。

Objective To investigate the diagnosis and s ur gical treatment of upper lumbar disc herniation. Methods Retrospective analysis was done on the clinical manifestation, positive sign, radiological findings, diagnostic and therapeutic methods, prognosis in 42 patie nts of upper lumbar disc herniation. Results 42 cases we re followed up for 1 to 5 years after the operation. According to modified Macna b grades, 25 cases(59.5%) were excellent, 13 cases (31.0%) good and 4 cases (9.5 %) fair, with a total excellent rate of 90.5%. Conclusions Clinical manifestation and neurological examination associated with MRI and C T are the important means of the diagnosis of upper lumbar disc herniation, surg ical treatment must be performed as early as possible.