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目的:探讨腰椎间盘突出症患者的临床症状与CT影像学检查进行相关性研究及原因分析。方法:共纳入符合要求的CT病理分型为膨出、突出、脱出的体检或住院或门诊患者326例,年龄22～58岁,平均39.6岁,用游标卡尺分别测量矢状径指数(si)、黄韧带前间隙、侧隐窝上口宽度、硬膜囊前后径。分别测量3次,取平均值。结果:腰椎间盘突出症患者的临床症状严重程度与CT检查测量的矢状径、突出面积、黄韧带间隙、侧隐窝宽度和硬膜囊前后径等有相关性,P<0.05。但是轻度与中度患者在黄韧带间隙、侧隐窝宽度等方面无相关性,P>0.05。中度与重度患者在右侧黄韧带间隙、侧隐窝宽度方面也无相关性,P>0.05。与腰椎间盘突出的性质和类型有相关性,P<0.05。但与突出的部位无相关性,轻度与中度、轻度与重度患者在椎间盘突出的性质和类型方面也无相关性,P>0.05。结论:腰椎间盘突出的大小、部位、类型与临床症状存在一定的必然关系。椎管内突出髓核是否导致相应的临床症状存在着诸多或必然因素,可能与椎间盘突出物可代偿的椎管储备容量、受累神经根对机械压迫的逃逸避让与弹性延长功能,以及受累神经根低氧消耗与抗缺血性损伤代偿作用等因素有关。
Objective: To investigate the correlation between the clinical symptoms of patients with lumbar disc herniation and CT imaging and the cause analysis. Methods: A total of 326 patients with physical examination or inpatient or outpatient service were enrolled in this study. 326 patients aged from 22 to 58 years with an average of 39.6 years old were enrolled. The sagittal index (si) Anterior gap of the ligamentum flavum, lateral recess width, anterior and posterior diameter of the dural sac. Measure 3 times separately, take the average value. Results: The severity of clinical symptoms in patients with lumbar disc herniation was correlated with the sagittal diameter, prominent area, ligamentum flavum, width of lateral recess and anteroposterior diameter of dural sac measured by CT (P <0.05). However, mild and moderate patients in the ligamentum flavum, lateral recess width, etc. no correlation, P> 0.05. Moderate and severe patients in the right ligamentum flavum, lateral recess width is not related, P> 0.05. Correlation with the nature and type of lumbar disc herniation, P <0.05. However, there was no correlation with prominent sites. There was no correlation between mild and moderate, mild and severe patients in the nature and type of disc herniation, P> 0.05. Conclusion: The size, location, type and clinical symptoms of lumbar disc herniation have certain inevitable relations. Spinal nucleus pulposus whether the corresponding clinical symptoms lead to the existence of many or inevitable factors, may be associated with disc herniation compensatory spinal canal reserve capacity, nerve root involvement of mechanical escape escaping and elastic elongation, and involvement of nerves Root hypoxia depletion and anti-ischemic injury compensatory effects and other factors.