椎间盘骨内突出症的临床研究

A clinical study of intervertebral disc intrabony-herniation

目的探讨椎间盘骨内突出症的分型和临床特点。方法对54例单纯Schmorl结节形成伴腰痛患者行非手术治疗,获取临床、影像资料,记录治疗前后的VAS评分。根据治疗效果,将患者分为满意组和不满意组,比较2组间各项资料的异同。结果 2组间在吸烟率、终板炎发生率、前屈试验阳性率、后伸试验阳性率上的差异具有统计学意义(P<0.05)。结论椎间盘骨内突出症是一种以Schmorl结节形成为主要病理改变,以腰痛为主要临床表现的疾病,其可分为轻度和重度2型。诊断重度椎间盘骨内突出症的关键是治疗前VAS评分≥5分,有终板炎或腰椎前屈应力试验阳性。

Objective To investigate the types, clinical features and diagnostic criteria of intervertebral disc intrabony- herniation. Methods Fifty four patients with Schmorl nodules and low back pain were followed up and accepted for conservative treatment. The clinical and image data were obtained, and the VAS scores were recorded before and after conservative treatment. According to conservative treatment, the patients were divided into unsatisfied group and satisfied group. The similarities and differences were compared between the two groups. Results The differences were statistically significant in smoking rate, endplate inflammation incidence rate, lumbar anteflexion test positive rate and lumbar extension test positive rate between the two groups （P 〈0.05）. Conclusion The intervertebral disc intrabony-hemiation is a disease that is within Sehmorl nodules formed as the main pathological changes and low back pain as the main clinical manifestations. It can be divided into two types, mild and severe. The keys to the diagnosis of severe intervertebral intrabony-hemiation is pre-treatment VAS score≥ 5 and endplate inflammation or lumbar anteflexion stress test is positive.