腰椎间盘突出症CT分型与硬膜外注射术疗效分析

Relationship between CT classification of lumbar disk herniation and therapeutic effects of epidural injection

目的：探讨硬膜外注射术治疗腰椎间盘突出症的适应证,以及不同CT分型患者的疗效差异。方法：采用胡有谷的影像学区域定位法分类,回顾性分析195例腰椎间盘突出症患者的治疗效果,其中男99例,女96例;年龄22~74岁。主要症状：腰痛,单侧下肢或双下肢的放射痛及皮肤痛觉减退,间歇性跛行等,均采用硬膜外注射术治疗。结果：疗效评定根据MacNab改良标准,突出物位于Ⅰ层、1区、2区、1-2区及a域,优良率分别为95.4%、92.6%、90.0%、84.3%、94.4%,疗效优于其他区域,差异有统计学意义。结论：硬膜外注射术是治疗腰椎间盘突出症的较好方法,而对于按胡有谷的CT区域定位法分类,突出物位于Ⅰ层、1区、2区、1-2区及a域的患者疗效更佳。

Objective：To explore the indication of epidural injection for the treatment of lumbar disk herniation,and to find relationship between its therapeutic effects and the CT classification.Methods：Among 195 patients reviewed in the study,99 patients were male and 96 patients were female,ranging in age from 22 to 74 years.The lumbar disc herniation of the patients were classified according to imaging regional location method defined by HU You-gu.The main symptoms included low back pain,radiating pain of single or double lower limb,skin hypoalgesia or intermittent limping.All the patients were treated with epidural injection.Results：According to modified Macnab criteria,prolapsed lumbar intervertebral discs were located at Ⅰ layer,1 section,2 section,1 to 2 section and a field.The excellent and good rates of the above region were 95.4%,92.6%,90.0%,84.3%,94.4% respectively,and the results had statistical differences.Conclusion：Epidural injection is a good method for the treatment of lumbar disc herniation.If the prolapsed lumbar intervertebral discs are located at Ⅰ layer,1 section,2 section,1 to 2 section and a field based on HU You-gu classification,the therapeutic effects are better.