摘要
我院从１９７０～１９８９年手术治疗腰椎间盘突出症５１２例，其中１０～２０岁发病者１９例，占椎间盘手术３．７１％。青少年的腰椎间盘突出仅在椎间盘存在缺陷或较明显外伤时发病。其临床表现与成年人有很大差异：腰腿痛较轻，神经功能改变较少见，而腰部异常僵硬，脊柱异常后突或侧弯，直腿抬高试验呈强阳性。体检常不易确诊及定位。由于明显外伤常致软骨终板破裂且与局部纤维环一起突入椎管，一般突出较大，非手术疗法常无效，手术应将突入椎管内之软骨板及纤维环一并摘除。
AbstractProtrusion of lumbar intervertebral disk(PLID)inthe adolescents occurred only in those with developmentaldefects of the disks or with an apparent trauma prior to theprotrusion. The clinical pictures were quite different fromthat seen in the adult patients .The backache and sciaticawere mild,and the neurological deficis less frequent how-ever, the lumbar spine on motion can be extraordinarilystiff, kyphotic and scoliotic deformity can be marked .Thestraight-leg raising test can be strongly positive, With theordinary examination methods,the diagnosis and localiza-tion lf the lesion can be very difficult,Due to the presenceof the fracture of the end plate of the disk from severe in-jury,the posterior portion of the annulus fibrosus can pro-uude into the lumbar canal with the end plate,so that thesize of the protrusion can be unusually targe and does notrespond to non-operative treatment.During surgery,theherniated disk should be extracted together with the endplate, From 1970 through 1989,a total of 512 cases ofPLID were treated surgically and 19(3.7%)cases oc-curred in the age range 10～20 years. All had conserva-tive treatment for more than 6 months without success.The PLID operations were performed with the posteriorapproach.17 cases had postoperative follow-up for anaverage of 6.2 years and excellent results were seen in 16cases(94%).
出处
《中华骨科杂志》
CAS
CSCD
北大核心
1994年第4期200-202,共3页
Chinese Journal of Orthopaedics
