临床体征和影像学检查对腰椎间盘突出症诊断价值

The comparison of Value of the Clinical Signs ,Plain Radiography,CT and Myelography in the Diagnosis ofLumbar Disc Herniation

作者统计了因腰椎间盘突出症手术治疗的３１２例病人的主要临床表现。综合部分文献资料的报道，共计临床查体诊断１１９３例，ＣＴ扫描诊断５３２例，脊髓造影诊断６３５例。各种诊断方法的手术符合率依次为９２．３％，８０．０％，９１．５％。统计显示，临床体征的诊断价值优于ＣＴ和造影，绝大部分病人仅据临床体征和Ｘ线平片即可确诊，对于ＣＴ和造影结果的分析，必须紧密结合全面详尽的体格检查。作者概括总结出９项临床诊断标准。

AbstractA statistieal study on the major clinical manifesta-tions of 312 cases of surgically treated lumbar disc hernia-tion(LDC)was made with a review of the literature,which included 1193 cases of LDC diagncoed with clinical physical examination,53 2 cases with CT and 635 cases with myelography,The operative coincident rates were 92.3%,80.0%and 9 1.5%respectively,The analysis revealed that in the great majority of cases, the dingncais can be made by the clinical signs with the aid of plain X-ray film. The diagnatic value of the clinical signs is better than CT and myelography. Analysis of the result of CT and myelography must be considered clasely with the find-ings of overall and thorough physical examination;addi-tionally,CT and myelography should only be used for the diagnasis of LDC with strict indieations following careful individual case analysis .