腰椎间盘突出症临床症状体征严重度与髓核突出方式关系探讨

目的：探讨腰椎间盘突出症（lumbar disc herniation，LDH）患者临床症状体征的严重度和髓核突出方式之间的相关性。方法：129例确诊为LDH患者，测量每例患者与髓核突出方式有关的CT指标（许莫氏结节、经骨突出、病理类型、突出位置、髓核疝出的密度、突出物的形状）。通过对患者体检了解症状体征的严重度，将症状体征严重度分为轻、中、重3个等级，再对症状体征严重度和CT指标进行Spearman秩相关检验和秩和检验。结果：许莫氏结节、经骨突出与LDH症状体征严重度的相关性无统计学意义。病理类型、突出位置、突出物密度、突出物形状等与LDH症状体征严重度的相关性有统计学意义（P〈0．01）。结论：病理类型、突出位置、突出物密度、突出物形状与LDH症状体征严重度密切相关，并且随着突出程度加重，LDH患者症状体征严重度有加重的趋势。

An Investigation of the Correlation between the Severity of the Symptoms and the Ways of Nucleus Pulposus Herniation (NPH) in Patients with Lumbar Intervertebral Disc Protrusion

objective. To investigate the correlation between the severity of the symptoms and the ways of nucleus pulposus herniation in patients with lumbar intervertebral disc protrusion. Methods： The CT Indexes （including schmorl nodus, NPH through bone, Pathological type, NPH density, NPH shape, NPH position） of 129 LDH patients were measured. The lumbar intervertebral disc protrusion sufferers were divided into 3 groups according to the severity of the symptoms and signs by physical examination. Then the correlation between the severity of the symptoms and CT indexes of the lumbar intervertebral disc protrusion was investigated using spearman rank correlation test and rank sum test. Results： There was no statistical significance between the schmorl nodus and the severity of symptoms and signs of lumbar intervertebral disc protrusion, the same as the NPH through bone（P〉0.05）. But the pathological type, the NPH density, the NPH shape, the NPH position existed statistical significance compared with the severity of the symptoms and signs of the lumbar disc herniation（P〈0.01）. Conclusion： The pathological type, the NPH density, the NPH shape, the NPH position affect the symptoms and signs of LDH. And the symptoms of the sufferers will aggravate as the lumbar intervertebral disc protrusion gets worse.