青年腰椎间盘突出症的发病及其诊治

The pathogenesis of juvenile lumbar intervertebral disc hernia and its diagnosis and treatment

报告青年腰椎间盘突出症２５例，以手法为主进行综合治疗，治愈率达８８％。临床观察表明，青年腰椎间盘突出症患者在椎间盘的生理特性、病理变化和临床特点等方面与儿童和少年腰椎间盘突出症存在着差异。患者发病除外伤和脊柱发育性结构异常等因素外，还有椎间盘退变因素。认为临床诊断命名应改变过去将儿童、少年和青年发病笼统概括为青少年腰椎间盘突出症和把发病年龄界定为２０岁以下的传统观点。要按照腰椎间盘突出症发病时的不同年龄时期，使诊断命名更为确切。临床治疗宜针对青年腰椎间盘突出症的发病和临床特点，视病情首选非手术疗法。

Twenty-five cases of juvenile lumbar intervertebral disc hernia (LIDH) were comprehensively treated mainly by manipulations with a curative rate of 88%. The clinical observation showed that juvenile LIDH is different from children's LIDH in the pathological characteristics, pathological changes and clinical features, etc. The pathogenic factots included the degenerated intervertebral discs as well as injury and developmental structural abnormality of the spine, etc. The authors suggested that the traditional idea in the clinical diagnostic nomenclature should be changed that the children's and juvenile diseases were generally summerized in juvenile LIDH and the limited age of the pathogenesis was defined as less than 20 years. The diagnostic nomenclature should be more defined on the basis of varied age periods of LIDH attack. Aiming at the pathogenic and clinical characteristics of the disease, the clinical treatment should be made according to the patient's conditions, and non-operative therapy should be first selected.