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目的 :探讨青少年腰椎间盘突出症的临床表现、诊断及手术治疗的特性。方法 :对 1993～ 1998年间我院手术治疗的 2 6例 18岁以内的病例进行回顾性分析。结果 :本组 2 6例占我院同期腰椎间盘手术 2 773例的 0 94%。有明确外伤的占 5 8%。临床主要表现为腰腿痛较轻 ,而腰部僵硬 ,脊柱后突或侧弯较成人多见 ,神经功能改变不多 ,直腿抬高试验多呈阳性。体检不易确诊及定位。CT检查在明确诊断方面有重要帮助。 2 6例均行椎板间孔开窗髓核摘除术。术后优良率达 96 %。结论 :其发病原因在于外伤或椎间盘发育缺陷 ,故常致软骨终板破裂且与局部纤维环一起突入椎管 ,一般突出物较大 ,非手术治疗无效 ,手术以选择简单的破坏性小的椎板间孔开窗 ,并应将突入椎管内的软骨终板及纤维环一并摘除。
Objective: To investigate the clinical manifestations, diagnosis and surgical treatment of adolescent lumbar disc herniation. Methods: A retrospective analysis was performed on 26 cases under 18 years of age operated in our hospital from 1993 to 1998. Results: The group of 26 cases accounted for 094% of the 2 773 cases of lumbar disc surgery in our hospital at the same period. A clear trauma accounted for 58%. The main clinical manifestations of lumbocrural pain lighter, while the waist stiffness, spinal kyphosis or lateral bending more common in adults, little change in nerve function, mostly straight leg raising test was positive. Physical examination is not easy to diagnose and locate. CT examination in a clear diagnosis of important help. Twenty-six patients underwent intercostal fenestration and nucleus excision. Postoperative excellent rate of 96%. Conclusion: The cause of the disease is traumatic or disc development defects, it often causes cartilage end-plate rupture and with the local annulus fibrosus into the spinal canal, the larger the general projection, non-surgical treatment ineffective surgery to select a simple destructive lamina Mianzhuo window, and should be inserted into the spinal canal end of the cartilage and fibrous annulus removed together.