腰椎间盘突出症的分型及其临床意义

The Classification into Different Types of Prolapsed Lumbar Intervertebral Disc

目的 对腰椎间盘突出症就蒋氏分类及其临床意义进行讨论。方法 根据腰椎间盘各组成部分及不同阶段的病理变化 ;从椎间盘到关节突关节 ,从软组织到骨结构 ,从青少年到中老年的病理特点 ,将椎间盘突出症分为软骨板破裂、弹力、退变失稳和增生狭窄四型。对 396例不同类型的治疗结果进行分析。结果 从 2 94例非手术治疗表明 ,弹力型优良率达 92 6 5 % ,增生狭窄型为 5 7 5 0 % ,两者有显著性差异 (P <0 0 5 )。手术治疗 10 2例 ,优良率为 92 16 %。结论 弹力型大多数可通过非手术达到满意结果 ,增生狭窄。

Objective [HT5”SS]To investigate the classification into different types of prolapsed lumbar interventebral disc(PLID) and its clinical significance [HT5”H]Methods [HT5”SS]Based on the fundamental analysis of the special pathological features of PLID in the adolescence,the middle aged and the elderly,as well as the structural changes in the intervertebral disc,including the soft and the osseous tissue,the authors classified the lesions of PLID into four different types:1 The ruptured annulous fibrosus type 2 The elastic protrusion of the intervertebral disc 3 The degenerated and the unstable PLID and 4 The hypertrophied lesion with spinal stenosis A total of 396 cases of the different types were reviewed [HT5”H]Results [HT5”SS]Among the 294 cases undergone conservative management,the elastic protrution type had excellent results in 92 65%,while in the hypertrophied and the stenosis group,the rate was 57 50%,demonstrating a significant difference ( P <0 05) One hundred and two cases were treated with surgery and the excellent rate was 92 16% [HT5”H]Conclusion [HT5”SS]Mostly the elastic protruded lesions can be effectively treated with conservative means and for the hyopertrophied lesions with spinal stenosis,and those with ruptured annulus fibrosus of the late stage,surgical treatment is the chief option [WT5”HZ]