本文選題：青少年 + 腰椎間盤突出癥　； 參考：《蚌埠醫(yī)學院》2012年碩士論文

【摘要】：腰椎間盤突出癥是指由于外傷或退變導致椎間盤纖維環(huán)破裂髓核膨出，突出或脫出，壓迫神經(jīng)根，脊髓，導致放射性神經(jīng)痛和神經(jīng)功能障礙，是腰腿痛常見的原因之一，多見于成年人，青少年發(fā)病率低。與成年人相比，青少年腰椎間盤損傷后有一定的自我修復能力，其發(fā)病機制，臨床表現(xiàn)與成年人有明顯區(qū)別,臨床上易延誤診斷,如診治不當可造成患者遺留嚴重的功能障礙。青少年椎間盤尚處于發(fā)育期，髓核中的水分較為充足，發(fā)生退變的機會較少，椎間盤退變并不是青少年腰椎間盤突出癥的主要原因，許多因素已經(jīng)確定為兒童腰椎間盤突出癥的潛在病因，如創(chuàng)傷，遺傳因素，移行椎，脊柱側彎等。青少年腰椎間盤突出癥的臨床表現(xiàn)與成年人有較大的差異，特點是癥狀比較少且相對較輕，體征相對較多而且較重，腰部畸形重，X線檢查常發(fā)現(xiàn)脊柱代償性側凸。青少年腰椎間盤突出癥的治療方法有多種，對于臨床癥狀較輕，初次發(fā)作，突出較小者可采用保守治療；保守治療失敗者可以嘗試化學性髓核溶解治療，經(jīng)皮內(nèi)窺鏡椎間盤摘除術，經(jīng)皮激光椎間盤減壓術；對于癥狀體征較嚴重，病史長，神經(jīng)癥狀明顯的患者，，多采用手術治療方法，手術方法有小切口椎板間開窗髓核摘除術，半椎板椎間盤切除術和全椎板髓核切除術；對于伴有腰椎滑脫或明顯腰椎不穩(wěn)，有較多椎板切除，椎間小關節(jié)失穩(wěn)的患者可采用腰椎融合術。
[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.
【學位授予單位】：蚌埠醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R687.3

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