青少年腰椎间盘突出症的病因学、治疗方案研究

Study on Etiology and Treatment Plan of Adolescent Lumbar Disc Herniation

目的探讨青少年腰椎间盘突出症的病因学和治疗方案。方法方便选取2016年10月-2018年3月该院收治的56例青少年腰椎间盘突出症患者,分析其发病原因,并将56例患者分为A组和B组,对A组实施椎间孔镜术治疗,对B组实施椎板间开窗术治疗,比较A组、B组手术并发症发生情况及术前、术后3个月的腰椎功能。结果 56例患者的病因外伤因素占比17.9%,发育异常占比25.0%,先天畸形因素占比10.7%,退变因素占比46.4%。A组手术并发症发生率为3.6%(1例发热),B组手术并发症发生率为21.4%(2例感染,3例发热,1例出血),对比A组显著低于B组,差异有统计学意义(P<0.05)。A组术前JOA评分为(18.2±4.5)分、术后3个月为(24.2±2.5)分;B组术前JOA评分为(18.9±4.8)分、术后3个月为(24.5±2.9)分;两组腰椎JOA评分比较差异无统计学意义(P>0.05)。结论青少年腰椎间盘突出症的病因学较复杂,包括内因和外因,椎间孔镜术为治疗该类型腰椎间盘突出症的安全、有效的方法,具有推广应用价值。

Objective To investigate the etiology and treatment of lumbar disc herniation in adolescents.Methods A total of 56 patients with lumbar disc herniation admitted to our hospital from October 2016 to March 2018 were convenient selected and enrolled.The causes of the disease were analyzed.56 patients were divided into group A and group B.Intervertebral foramen were performed in group A.For the treatment of group B,the treatment of interlaminar fenestration was performed.The complications of group A and group B and the lumbar function of the group before and 3 months after operation were compared.Results The pathogenic and traumatic factors accounted for 17.9% of 56 patients,the developmental abnormalities accounted for 25.0%,the congenital malformation factors accounted for 10.7%,and the degenerative factors accounted for 46.4%.The incidence of operative complications in group A was 3.6%(1 case of fever),and the incidence of operative complications in group B was 21.4%(2 cases of infection,3 cases of fever,1 case of hemorrhage),and the comparison group A was significantly lower than group B.Statistically significant (P<0.05).The preoperative JOA score was (18.2±4.5)points in group A and (24.2±2.5) points in 3 months after operation.The preoperative JOA score was (18.9±4.8)points in group B and (24.5±2.9)points of 3 months after operation;there was no significant difference in the JOA scores between the two groups (P>0.05).Conclusion The etiology of lumbar disc herniation in adolescents is complex,including internal and external causes.Intervertebral foramen is a safe and effective method for the treatment of this type of lumbar disc herniation.