腰椎间盘突出症CT影像定位与症状体征的关联性分析

Correlation analysis on CT manifestations of lumbar disc herniation and symptoms and signs

目的探讨腰椎间盘突出症CT影像区域定位与症状体征的关联性。方法共选取258例腰椎间盘突出症患者,其中轻度120例,中度98例,重度40例,分别测量并计算出矢状径指数(SI)、测量黄韧带前间隙、侧隐窝上口宽度、硬膜囊前后径,观察腰椎间盘突出症分级与各项指标的关系,同时,根据CT检查将患者腰椎间盘突出性质、类型及部位进行分类,分析患者分级与腰椎间盘突出因素的关系。结果腰椎间盘突出症患者体征症状越严重,矢状径越大及硬膜囊前后径越小,即患者体征严重程度与矢状径及硬膜囊前后径有明显相关性(P<0.05)。轻度与重度组间比较,黄韧带间隙及侧隐窝宽度有显著差异,但轻度与中度及中度与重度组间比较差异无统计学意义,即腰椎间盘突出症患者体征症状严重程度与黄韧带间隙及侧隐窝宽度有一定关系,但不具有明显相关性。患者的临床症状体征严重程度与腰推间盘突出的性质和类型有明显相关性(P<0.05),与突出部位无明显相关性(P>0.05)。结论腰推间盘突出患者临床症状体征可由多种原因引起,其严重程度与CT影像学表现有一定的关系,但并不完全相关,应结合患者症状体征及各种检查结果进行综合考虑,正确评估患者病情。

Objective To investigate the correlation between CT manifestations of lumbar disc herniation and symptoms and signs. Methods A total of 258 patients of lumbar disc herniation were enrolled in the study, in- cluding 120 patients of mild, 98 patients of moderate and 40 patients of severe. The sagittal index （SI）, the space ante- rior to the ligamentum flavum, width of the superion outlet, the diameter of dural sac were measured and calculated. The correlation between the grade of lumbar disc herniation and the indexes were observed. According to the CT per- formanees, the nature, type and site of lumbar disc herniation, were classified, and the relationship between with the grade and the factors of lumbar disc herniation. Results Worse the signs and symptoms were, larger the sagittal diam- eter was and smaller the diameter of dural sac was, which indicated that there were a significant correlation between the symptoms severity, the sagittal diameter and the dural sac diameter （P〈0.05）. The space anterior to the ligamentum fiavum and the width of the superion outlet showed statistically significant difference between the mild group and the severe group, with no statistically significant difference between the mild group and the moderate group, as well as the moderate group and the severe group, which indicated that there was a certain correlation between the symptom severi- ty and the space anterior to the ligamentum flavum and the width of the superion outlet, but not obvious. Symptom se- verity also showed a significant correlation with the nature and type of lumbar disc herniation （P〈0.05）, with no signif- icant correlation with the site （P〉0.05）. Conclusion The clinical symptoms and signs of lumbar disc herniation can be caused by a variety of reasons. The symptom severity and imaging findings have a certain relationship, but not complete. We should combine the symptoms and signs with the examination results to assess the disease status of the patients correctly.