腰椎滑脱合并椎间盘突出的影像学研究及临床意义

The imaging study of spondylolisthesis with lumbar disc herniation and its clinical significance

目的 :探讨腰椎滑脱合并椎间盘突出的影像学及临床特点。方法 :回顾分析 6 9例腰椎滑脱合并椎间盘突出患者手术前后的临床症状、体征、X线片和CT。结果 :①腰痛伴坐骨神经痛 45例(6 5 2 % )。②突出椎间盘与滑脱椎体同一平面 42例 (6 1% )。③L4 / 5椎间盘突出 35例 (5 0 9% )。④椎间盘突出旁侧型 5 9个 (5 9 1% ) ,旁中央型 2 2个 (2 5 % ) ,中央型 14个 (15 % )。⑤术后 48例获随访 ,平均随访 3 5年 ,依Macnab评定标准 ,优 :38例 ,良 :7例 ,可 :3例。结论 :腰椎滑脱合并椎间盘突出以同一间隙旁侧型突出多见 ,好发于L4 / 5,主要症状为腰痛伴坐骨神经痛。纠正滑脱同时处理突出椎间盘 ,可取得满意疗效。

Objectives:To study the imaging characteristics of spondylolisthesis with lumbar disc herniation and its clinical significance.Methods:Sixty nine cases were analysized with their symptoms,signs,X ray film and CT scan before and after operation.Results:①Lumbago with ischialgia was found in 45 cases(65.2%).②Herniated discs and slippage were at the same lumbar level in 43 cases(61%).③Herniated disc occurred at L 4/5 in 35 cases(50.9%).④Disc was classified as lateral disc herniation in 52(59.1%)cases,paracentral disc herniation in 22(25.0%)cases,central disc herniation in 14(15.9%)cases.⑤Forty eight patients of 69 cases were followed up for average of 3.5 years.According to Macnab's standards,outcome was excellent in 35 cases,good in 9,fair in 4 cases.Conclusions:Herniated discs,predominantly cases.classfied as lateral disc herniation,and slippage are mostly at the same lumbar level,espescially at L 4/5 level.The main symptom is lumbago with ischialgia.During the operation,discectomy can result in completely decompression and good outcomes.