青少年腰椎间盘突出症的诊断与治疗

摘要

Objective To study the etiology and treatments of lumbar disc herniations (LDH) in adolescents. Method Nine patients who had suffered from LDH in adolescents were operated on by mini-incision unilataral/bilataral decompression by fenestration and nucleus pulposus extraction. Result All the patients were followed up for 1 to 6 years(mean 3 years and 2 months). In 7 cases the pain on lumber and leg completely disappeared, another two cases suffered from little pain when they were tired, relieved after resting. Conclusion Epiphyseal separation caused by trauma is the major etiopathogenisis of adolescent LDH. Straight-leg raising test positive is an important physical sign.CT can make final diagnosis. For the cases with severe symptoms and the dural sac and nerve root are apparent compressed by CT view and no results by conservative treatment, active surgery is needed.%目的 分析研究青少年腰椎间盘突出症的病因及治疗.方法 对9例青少年腰椎间盘突出症患者行小切口单侧/双侧开窗减压、髓核摘除术.结果 9例均获得随访,随访时间12～72个月,平均38个月,7例腰痛及下肢放射痛完全消失;2例劳累后有轻微症状,休息后可缓解.结论 外伤所致骺离骨折为青少年腰椎间盘突出重要病因,直腿抬高试验阳性为重要体征,腰椎CT可确诊.对于保守治疗无效或症状明显、CT证实硬膜囊及神经根明显受压者,应积极手术治疗.