未成年人腰椎间盘突出症的治疗策略.doc

未成年人腰椎间盘突出症的治疗策略 夏海鹏 邹云雯 褚言琛 王进 李东梅 【摘要腰背痛手术评分标准进行评价：33例患者中，优27例, 良4例, 可2例, 差0例，优良率为93.9%。 结论 未成年人腰椎间盘突出症患者的特点通常为突出物（髓核）多较大，且出现神经损害症状多较早和较严重。我们体会：对此类患者应做到早期正确诊断，及时有效治疗，减少并发症。故多数患者需要尽早行手术干预。 【关键词herapeutic Strategy of Lumbar Disc Herniation in the Minors XIA Hai-peng, ZOU Yun-wen, CHU Yan-chen, WANG Jin, LI Dong-mei. Department of Orthopaedic. The Affiliated Hospital of Medical College, Qingdao University, Qingdao, Shandong266000, China 【Abstract】Objective Exploring the clinical characteristics and therapeutic strategy of lumbar disc herniation of the minors, which aims to improve diagnostic accuracy and the cure rate. Methods Review the clinical materials of 33 minors with lumbar disc herniation and analyze the clinical characteristics and correctness of early diagnosis, the effectiveness of treatment and evaluate the efficacy and excellent and good rate. Results All 33 patients were followed up for 6 months to 7 years, among whom 27 cases were graded as excellent, while 4 cases were good and 2 cases were fair after the operation and excellent and good rate was 93.9%. Conclusions The lumbar disc protrusions are mostly large and mostly with severe and early symptoms of neurobiological impairments in the minors. We consider that it is necessary to conduct early and correct diagnosis and do timely and effective treatment as well as reducing complications. As a result, most of these patients are supposed to be given early surgical intervention. 【Key words】: minor; lumbar disc herniation; therapeutic strategy 腰椎间盘突出症是腰腿痛的最常见的原因之一，发病年龄多在20～40岁之间[1]，然而近年来, 未成年人腰椎间盘突出症发病呈上升趋势，引起我们的关注。一般认为未成年人的腰椎间盘正处于发育阶段, 尚未开始发生退行性变，保守治疗常可以取得较好的疗效。但经长期的临床实践发现, 部分未成年人患者腰椎间盘突出物（髓核）多较大, 出现神经损害的症状多较早，程度多较严重, 多数患者需要尽早施行手术治疗。我院自2005年2月～2012年12月共施行手术治疗未成年人腰椎间盘突出症患者33例，疗效满意, 现报道如下： 1 资料与方法 1. 1 一般资料 本组33例，男性21例，女性11例，年龄14~ 18岁,平均16.8岁。病程2~ 6个月，平均3个月; 腰椎间盘突出部位: L4-5 17例; L5-S1 12例；L4-5合并L5-S1 3例；L3-4合并L5-S1 1例；18例有明显外伤史，中央型腰椎间盘突出症患者22例。 1. 2 症状及体征 主要症状是腰腿痛，腿痛以大腿后方为主，有3例患者以臀部疼痛为主。腰痛伴下肢放射痛患者26