以腰臀部疼痛为主的腰椎间盘突出症

The lumbar intervertebral disc herniation with clinical manifestations characterized by the hip pain

目的探讨对于临床表现主要为腰臀部疼痛的腰椎间盘突出症患者的有效治疗方法。方法回顾性分析了87例主要表现为腰臀部疼痛的腰椎间盘突出症患者,入院后直接手术者32例,先行牵引等保守治疗1月左右无效而改行手术者23例,一直行保守治疗者32例。结果所有患者均获得随访,时间:5月～7年,平均3年5月。手术患者根据中华骨科学会脊柱学组腰背痛手术评定标准评定:优良率89.1%。保守治疗患者根据Tauffer和Coventry腰椎间盘突出症疗效标准评定:良好率84.3%。结论对于初次发作或病史少于3个月者,应采用保守治疗;而对于反复发作,病史超过半年,腰臀部疼痛严重,经保守治疗无效者应果断采取手术治疗。

Objective To explore effective treatment methods for herniated lumbar intervertebral disc patients with clinical manifestations characterized by the hip pain.Methods An retrospective analysis were done for 87 herniated lumbar intervertebral disc patients characterized by the hip pain,32 cases of them treated with surgery after admission,another 23 cases received initiated conservative treatment including traction about one month and were switched into surgery when the treatment showed no significant effects,the rest 32 cases received conservative treatment only.Results All cases were obtained follow-up of five mouths to seven years,averaged three years and five months.According to the surgical assessment standard of Chinese Orthopaedic Association Spine Study Group for treatment of the low back pain,the excellent and good rate for patients after surgery was 89.1% percent;and correspondingly for patients receicing conservative therapy,the good rate reached 84.3 percent based on efficacy evaluation standard of Tauffer and Coventry for lumbar intervertebral disc herniation.Conclusion For initial history or less than three months,the conservative treatment should be adopted,however for more than half a year history of recurrent and severe hip pain the positive surgical treatment is more benefiacil when the conservative treatment was not significantly effective.