摘要
目的:分析腰椎间盘突出症患者腰臀部压敏点分布与MRI影像学表现间的关系。方法:选择2015年8月至2016年8月于广西柳州市中医院脊柱外科住院治疗的LDH患者共136例,均行X线片及MRI确诊为腰椎间盘突出症患者。其中男75例、女61例;年龄19~67岁,平均(47.47±11.54)岁;病程1d^3个月,平均(11.74±11.23)d.所有患者均表现为腰痛伴单侧下肢神经根支配区放射性麻胀痛,其中L_(3~4)为9例,L_(4~5)为64例,L_5S_1为63例。收集患者腰臀部压敏点分布情况及在MRI上明确突出节段、突出类型及改良Pfimnann椎间盘退变分级情况。利用SPSS_19.0的对应分析模块对LDH患者腰臀部压敏点与MRI影像表现进行相关性研究。结果:突出节段方面:L_(3~4)突出最常见压敏点为腰三横突;L_(4~5)突出最常见压敏点为臀上皮神经、梨状肌;L_5S_1突出最常见压敏点为髂腰韧带。不同突出类型在压敏点分布上差异无统计学意义(P>0.05)。椎间盘退变分级方面:Ⅵ级最常见压敏点为梨状肌;Ⅶ级最常见压敏点为臀上皮神经、髂腰韧带;Ⅷ级最常见压敏点为棘突及棘间。结论:腰椎间盘突出症患者腰臀部压敏点与MRI影像学存在一定联系,可应用于腰椎间盘突出症的中医外治。
Objective：To analyze the relationship between the distribution of waist and buttock trigger points and MRI imaging findings in patients with lumbar disc herniation.Methods：136 LDH patients hospitalized in spinal surgery in our hospital from August 2015 to August 2016 were selected,and all the patients were diagnosed with lumbar disc herniation by X-ray and MRI.There were 75 males and 61 females,aged 1967 years,with an average of（47.47±11.54）years.The course of disease was 1 days-3 months,with an average of（11.74±11.23）days.All patients presented with low back pain accompanied by radiated pain in unilateral side,including 9 cases of L3-4,64 cases of L4-5,and 63 cases of L5 S1.The distribution of waist and buttock trigger points was collected,and the prominent segments,types of protrusion and the grading of the Pfimnann intervertebral disc degeneration were clearly defined on the MRI.The corresponding analysis module of SPSS19.0 was used to study the correlation between MRI images and waist and buttock trigger points in LDH patients.Results：Prominent segments：the most common trigger points was the lumbar three transverse process in L3-4;the most common trigger points were the superior clunial nerve,piriformis in L4-5;the most common trigger points was iliolumbar ligament in L5 S1.There was no significant difference in the distribution of waist and buttock trigger points between different outburst types.Grading of disc degeneration：the most common trigger points at gradeⅥis piriformis;the most common trigger points in gradeⅦ are the superior clunial nerve,iliolumbar ligament,and the most common trigger points at gradeⅧ are spinous processes and interspinous.Conclusion：The waist and buttock trigger points in lumbar disc herniation are related to MRI imaging.They can be applied to the external treatment of lumbar disc herniation.
作者
梁冬波
李剑峰
王力平
LIANG Dongbo1, LI Jianfeng1, WANG Liping1(1 Department of Spinal Surgery, the Third Affiliated Hospital of Guangxi Traditional Chinese Medicine College, Liuzhou 545001, Guangxi Chin)
出处
《中国中医骨伤科杂志》
CAS
2018年第4期45-49,53,共6页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
基金
广西(柳州市)科学研究与技术开发计划(2015J030503)
广西柳州市正高级职称人才协会软科学研究项目
关键词
腰椎间盘突出症
椎间盘退变
腰臀部压敏点
lumbar disc herniation
disc degeneration
trigger points of waist and buttock
