摘要
目的:探讨青少年型腰椎间盘突出症的发病原因、临床特点和治疗方式的选择.方法:总结我院1993～2001年间40例21岁以下的腰椎间盘突出症患者的临床资料,其中采用保守治疗7例,单侧椎板开窗术治疗16例,半椎板切除术治疗14例,双侧椎板开窗术治疗3例.随访时间3～10年,平均(4.2±0.6)年,并采用JOA评分对不同治疗方法的疗效进行评估.结果:40例患者治疗后腰痛及腿痛症状均得到了不同程度的缓解,手术组治疗后无患者出现原有症状加重情况.随访时发现8例手术治疗患者偶尔有轻度腰痛,但不影响生活;2例非手术治疗患者仍存在感觉麻木;手术组患者未发现明显腰椎退变情况.手术组JOA评分改善优于非手术组,各组治疗前后JOA评分差值有统计学意义(P<0.05),不同手术方式之间则无显著性差异.结论:青少年型腰椎间盘突出症患者的临床表现与成年人有很大差异,表现为症状较轻但体征较重;在诊断上,体征、影像学改变比症状可靠;治疗上宜采取手术治疗.
Objective： To investigate the pathogenesis, clinical feature and alternative approach of lumbar disc herniation in teenagers, Methods： The clinical data of 40 inpatients （age≤21 years, admitted in Changhai Hospital from 1993 to 2001） with lumbar disc herniation were retrospectively reviewed. Of them, 7 patients received conservative treatment and the remaining underwent operation, including interlaminar partial laminotomy on one side （16 patients）, hemilaminar laminotomy （14 patients） and interlaminar partial laminotomy on both sides （3 patients）. All patients were followed up for 3 to 10 （4.2±0.6） years, Follow-up evalutions were performed via clinical visits, The Japanese Orthopaedic Association＇s evaluation system for lower back pain syndrome （JOA score） was used to evaluate the outcomes. Results： The lumbar and leg pain was released in all 40 patients after therapy, There was no deterioration of symptoms in the operative groups. During the follow-up, 8 patients had occasional low back pain but it did not affect their lives, 2 patients in the non-operative group had numbness, and no patients had lumbar degeneration in the operative groups. The improvement of JOA score was more significant in operative groups than in the non-operative group. There were significant differences in JOA scores before and after treatment in all groups （P〈0.05）, but there was no significant difference between different operative groups. Conclusion, The clinical manifestations of lumbar disc herniation are significantly different between adults and teenagers. Symptoms of teenagers are slighter and signs are severer than those of adults. For diagnosis, signs and image changes are more reliable than symptoms, for treatment, operation should be chosen.
出处
《第二军医大学学报》
CAS
CSCD
北大核心
2005年第9期1053-1056,共4页
Academic Journal of Second Military Medical University
关键词
青少年
腰椎间盘突出症
诊断
治疗
adolescent
lumbar disc herniation
diagnosis
treatment
