椎间隙突出髓核内压力与相邻神经根受压程度的临床研究
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作者Author单位AddressE-Mail
冯宇 FENG Yu 空军总医院全军正骨疗法中心, 北京100036 The General Hospital of Air Force  
卫杰 WEI Jie 空军总医院全军正骨疗法中心, 北京100036 The General Hospital of Air Force  
高燕 GAO Yan 空军总医院全军正骨疗法中心, 北京100036 The General Hospital of Air Force  
冯天有 FENG Tian-you 空军总医院全军正骨疗法中心, 北京100036 The General Hospital of Air Force  
期刊信息:《中国骨伤》2004年,第17卷,第11期,第665-667页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz
基金项目:
中文摘要:

目的:观察腰椎间盘突出症患者突出髓核内压力与神经根受压程度的关系。探讨突出髓核组织的临床意义及手法治疗的机制。

方法:选取腰椎间盘突出症手术患者30例,根据直腿抬高试验分为直腿抬高阳性组、阴性组,术中测量患者突出髓核内压力大小、观察突出髓核内压力与直腿抬高高度的关系;同时选取收治的手法治疗腰椎间盘突出症患者30例,观察手法治疗后直腿抬高高度的变化。

结果:①手术患者中直腿抬高阳性组患者突出髓核内压力明显高于阴性组患者,具有显著意义(P<0.01)。两组患者突出髓核大小无明显差异(P>0.05)。②手法治疗患者中手法治疗后直腿抬高高度明显增加(P<0.01),手法治疗前后CT或MRI显示突出髓核大小无改变(P>0.05)。

结论:①突出髓核对神经根的压迫与突出髓核内压力有关,突出髓核内压力较大时患者直腿抬高受限,突出髓核内压力较小时直腿抬高不受限。突出髓核对神经根的压迫与突出髓核大小尚未见明显关系。②推测手法治疗可以通过降低突出髓核内压力减轻甚至解除神经根受压,可能不是仅依靠改变突出髓核空间占位达到治疗目的。
【关键词】椎间盘移位  压力  神经根压迫
 
Clinical study on the relation between the pressure of protruded nucleus pulposus of the lumbar disc and the degree of the nearby nerve root compression
ABSTRACT  Objectives:To observe the relationship between the pressure of protruded nucleus pulposus and the degree of the nerve root compression of patients with lumbar disc herniation,and to study the clinical significance and the mechanism of manipulative treatment for the protruded nucleus pulposus.

Methods:Thirty patients of lumbar disc herniation with operation were selected.According to the straight-leg raising test the patients were divided into positive group and negative group.During the operation the pressure of protruded nucleus pulposus were measured and the relationship between the pressure and the height in straight-leg raising test was observed.Meanwhile thirty patients of lumbar disc herniation with manipulative treatment were selected and observed the changes of the height in straight-leg raising test after manipulative treatment.

Results:①There was significant difference in the pressure of protruded nucleus pulposus between positive group and negative group(P<0.01),and there were no significant difference between the two groups in the nucleus pulposus sizes (P>0.05).②In the patients with manipulative treatment,the height in straight-leg raising test was significantly higher compared with the pre-therapy(P<0.01).There was no significant changes in the size of nucleus pulposus before and after therapy by CT or MRI scanning(P>0 05).

Conclusion:①There are obvious relationship between the pressure of protruded nucleus pulposus and the degree of the nerve root compression.The stronger the pressure was,the more the heighter was limited in straight-leg raising test.There are no obvious relationship between the sizes of protruded nucleus pulposus and the degree of the nerve root compression.②The successful manipulative treatment may not only depend on changing the space occupation of protruded nucleus pulposus,but also depend on reducing its pressures to relieve and even eradicate the nerve root compression to achieve the therapeutic goal.
KEY WORDS  Intervertebral disc displacement  Pressure  Nerve root compression
 
引用本文,请按以下格式著录参考文献:
中文格式:冯宇,卫杰,高燕,冯天有.椎间隙突出髓核内压力与相邻神经根受压程度的临床研究[J].中国骨伤,2004,17(11):665~667
英文格式:FENG Yu,WEI Jie,GAO Yan,FENG Tian-you.Clinical study on the relation between the pressure of protruded nucleus pulposus of the lumbar disc and the degree of the nearby nerve root compression[J].zhongguo gu shang / China J Orthop Trauma ,2004,17(11):665~667
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