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1、中国中医骨伤科杂志2002年10月第10卷第5期13·论 著·影像学区域定位在腰椎间盘突出症中的应用孙 波 吴云定 李麟平 陈建华 彭宗泽(上海市卢湾区香山中医医院施氏伤科 上海 200020)摘要 目的:依据CT或MRI显示的腰椎间盘的影像,探讨区域定位方法在中医药治疗腰椎间盘突出症中的应用价值。方法:运用胡有谷提出的区域定位方法对46例腰椎间盘突出症病例进行分析。结果:(1)本组58例病例中,单纯膨出者12例,46例(54节段)腰椎间盘突出(31例伴有膨出)患者中,涉及É层节段数占68.5%,É～Ê层占11.1%,É～Ë层
2、占20.4%;涉及É区节段数占29.6%,2区占33.3%,1～2区占25.9%;涉及a域节段数占33.3%,b域占59.3%,c域占7.4%。(2)本组58例病例,采用改良日本骨科学会下腰痛评分法,总有效率98.3%,优良率为87.9%。结论:(1)腰椎间盘突出症好发于L4～5、L5S1节段,并且常常伴有椎间盘膨出。(2)区域定位方法可以很好的判断出腰椎间盘突出的病理类型,方向和严重程度。(3)中医药综合治疗方法是有效的、痛苦少、适用范围较广的治疗措施,应该推广应用为保守治疗的主要措施。关键词 腰椎 椎间盘移位 影像学 区域定
3、位中图分类号:R681.5 文献标识码:A 文章编号:1005-0205(2002)05-0013-03ClinicalStudyoftheTree-dimensionalLocalizationoftheHerniationofLumbarDiscSunBo,WuYunding,LiLinping,etalShi'sTraumatologicDepartment,XiangshanHospitalofT.C.M.,Shanghai200020ABSTRACTObjective:Toexploretheclinicalsig
4、nificanceonthetree-dimensionallocalizationoftheherni2ationoflumbardiscaccordingtothemorphologyoftheherniationoflumbardiscshowedbyCTorMRI.Method:Usingthetree-dimensionallocalizationestablishedbyProfessionHuyougu,46casesinall58caseswerestatisticallyanalysed.Results:(1)
5、Inthisseries,12caseswerediagnosiedoflumbardiscexpansion,and31casescombinedwiththeexpansionoflumbardiscin46casesoflumbardischerniation.Thethree-dimen2sionallocalizationwascarriedoutasfollow:Sagittalplane:Élevelof68.5%,É-Êlevelof11.1%,É-Ëof20.4%;Horizontalplane:1zoneof
6、29.6%,2zoneof33.3%,1-2zoneof25.9%;Frontalplane:aareaof33.3%,bareaof59.3%,careaof7.4%.(2)AssessedbymodifiedJOAlowbackpainscores,57(98.3%)inthis58casesobtainedexcellentresult.Conclusion:(1)BothL4～5andL5S1segmentswereeasytoresultinLDH.(2)Thetree-dimensionallocalizationi
7、susefulfortheestablishmentofanaccuratedisgnosis,forthepredictionoftheseverityofthedischerniation,aswellasfortheevaluationoftreatmentresulty.(3)Thema2nipulationandchineseherboftraditionalchinesemedicineareeffective,lowpainandconveniencemanagen2ment,andshouldbecomeamaj
8、ornon-operationmanagement.KEYWORDSLumbarvertebraeIntervertebraldiscdisplacementCTorMRITree-di2mensionallocalization 区域定位是著名腰突症专家胡有
