腰椎间盘突出症患者的下肢压痛点及其临床意义

TENDERNESS POINTS IN THE LOWER EXTREMITY AND THEIR CLINICAL SIGNIFICANCE IN PATIENTS WITH LUMBAR DISC HERNIATION

目的: 研究腰椎间盘突出症患者的下肢压痛点并探讨其临床意义。方法: 检查174 名腰椎间盘突出症患者下肢臀中肌、臀大肌、股四头肌、股二头肌、半腱半膜肌、胫骨前肌、腓肠肌内侧头和腓肠肌外侧头以及坐骨神经、胫神经共计10 个压痛点。结果:127 名患者(73 % ) 存在下肢压痛点, 但L4 ～5 椎间盘突出与L5 ～S1 突出患者的阳性率无显著差别( P> 0 .05) 。压痛点总数与年龄成正相关( P < 0 .05) , 与直腿抬高试验阳性角度成负相关( P < 0 .01) , 但与病程无显著相关性( P > 0 .05) ,与JOA( 日本骨科学会) 评分无显著相关性( P> 0 .05) 。结论: 下肢压痛点检查对于腰椎间盘突出症具有一定诊断学意义。

Objective: To assess tenderness points in the lower extremity and its clinical significance in patients with lumbar disc herniation. Methods: One hundred and seventy four patients with lumbar disc herniation were examined for tenderness points in the gluteus medius, gluteus maximus, quadriceps femoris, biceps femoris, semitendinosus and semimembranosus, tibialis anterior, medial gastrocnemius, lateral gastrocnemius, sciatic nerve and tibial nerve. Results: Of these patients, there were 127 (73%) having tenderness points, but no differences were noted between the patients with disc herniation at L 4～5 and those at L 5～S 1 levels. Total number of tenderness points was positively related to the age of patients (P<0.05) and negatively related with the angle of straight leg raising (P<0.01)but not related with the duration of disease and JOA (Japanese Orthopaedic Association) scoring (P>0.05).Conclusion: Examination of tenderness points in the lower extremity is of value for the diagnosis of lumbar disc herniation.