青少年腰椎间盘突出症治疗进展

发布时间：2018-04-23 02:18

本文选题：青少年 + 腰椎间盘突出症　；参考：《蚌埠医学院》2012年硕士论文

【摘要】：腰椎间盘突出症是指由于外伤或退变导致椎间盘纤维环破裂髓核膨出，突出或脱出，压迫神经根，脊髓，导致放射性神经痛和神经功能障碍，是腰腿痛常见的原因之一，多见于成年人，青少年发病率低。与成年人相比，青少年腰椎间盘损伤后有一定的自我修复能力，其发病机制，临床表现与成年人有明显区别,临床上易延误诊断,如诊治不当可造成患者遗留严重的功能障碍。青少年椎间盘尚处于发育期，髓核中的水分较为充足，发生退变的机会较少，椎间盘退变并不是青少年腰椎间盘突出症的主要原因，许多因素已经确定为儿童腰椎间盘突出症的潜在病因，如创伤，遗传因素，移行椎，脊柱侧弯等。青少年腰椎间盘突出症的临床表现与成年人有较大的差异，特点是症状比较少且相对较轻，体征相对较多而且较重，腰部畸形重，X线检查常发现脊柱代偿性侧凸。青少年腰椎间盘突出症的治疗方法有多种，对于临床症状较轻，初次发作，突出较小者可采用保守治疗；保守治疗失败者可以尝试化学性髓核溶解治疗，经皮内窥镜椎间盘摘除术，经皮激光椎间盘减压术；对于症状体征较严重，病史长，神经症状明显的患者，，多采用手术治疗方法，手术方法有小切口椎板间开窗髓核摘除术，半椎板椎间盘切除术和全椎板髓核切除术；对于伴有腰椎滑脱或明显腰椎不稳，有较多椎板切除，椎间小关节失稳的患者可采用腰椎融合术。
[Abstract]:Lumbar disc herniation is one of the most common causes of lumbago and leg pain, which is caused by trauma or degeneration of disc fiber ring ruptured nucleus pulposus bulge, protruding or protruding, compression of nerve root, spinal cord, leading to radiation neuralgia and neurological dysfunction. It is more common in adults and has a low incidence among adolescents. Compared with adults, adolescents have a certain ability of self-repair after lumbar disc injury, its pathogenesis, clinical manifestations and adults have obvious differences, clinical diagnosis is easy to delay, such as improper diagnosis and treatment can lead to serious functional disorders left over by patients. The intervertebral disc is still in the developmental stage, the water in the nucleus pulposus is abundant, the chance of degeneration is less, the degeneration of intervertebral disc is not the main cause of lumbar disc herniation. Many factors have been identified as potential causes of lumbar disc herniation in children, such as trauma, genetic factors, transitional vertebrae, scoliosis, etc. The clinical manifestation of adolescent lumbar disc herniation is different from that of adults, which is characterized by less and lighter symptoms, more and more signs, and compensatory scoliosis often found in X-ray examination of lumbar deformities. There are a variety of treatment methods for adolescent lumbar disc herniation. For the patients with mild clinical symptoms, the patients with minor herniation may be treated conservatively, and those who fail in conservative treatment may try chemical nucleolysis of the pulpoid. Percutaneous endoscopic discectomy, percutaneous laser disc decompression; for patients with severe symptoms and signs, long history and obvious neurological symptoms, most of the patients were treated with surgical treatment, with small incision interlaminar fenestration of the nucleus pulposus. For the patients with lumbar spondylolisthesis or obvious instability of lumbar vertebrae, more laminectomy and instability of intervertebral facet joint could be performed by lumbar fusion.
【学位授予单位】：蚌埠医学院
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R687.3

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