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頁籤選單縮合
題名 | Intervertebral Disc Herniation in Adolescents=青少年的椎間盤突出 |
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作者 | 陳力輝; 張嘉獻; 李宗料; 牛自健; 賴伯亮; 譚芷峰; 陳文哲; Chen, Lih-huei; Chang, Chia-hsieh; Lee, Zhon-liau; Niu, Chi-chien; Lai, Po-liang; Tan, Chih-feng; Chen, Wen-jer; |
期刊 | 長庚醫學 |
出版日期 | 20040100 |
卷期 | 27:1 2004.01[民93.01] |
頁次 | 頁22-28 |
分類號 | 416.61 |
語文 | eng |
關鍵詞 | 青少年; 椎間盤突出; 腰椎環骺斷裂; Disc herniation; Adolescent; Apophyseal ring fracture; |
中文摘要 | 背景:對青少年椎間盤突出的外科病例進行研究,並著重於與成人椎間盤突出的異同。 方法:28位年紀介於14至18歲的椎間盤突出病人於何守療法達9個月後進行手術,腰椎電腦斷層顯示10位病人(42%)有椎體環□斷裂。7位病人接受椎間盤及環□切除術,其中4位斷裂的環□位於外側,壓在神經根上,3位斷裂的環□於中央,明顯造成硬脊膜的壓跡。 結果:術前病人的坐骨神經炎病狀於術後獲得緩解,除3位病人外皆可直腿抬高超過70度,術後平均6.1年的追蹤顯示,93%的病人有良好預後。2位病人因復發性椎間盤突出及傷口感染而再次手術。 結論:外科手術是解除症狀及早日讓青少年返回正常學校生活動首選療法。早期電腦斷層檢查可及早發現腰椎環□斷裂此一導致何守療法無效的因子,若斷裂的環□造成神經壓迫,可於椎間盤手術時一併切除。 |
英文摘要 | Background: The purpose of this study was to review surgery-proven lumbar disc hermiation in adolescents with an emphasis on the distinguishing features. Methods: Twenty-eight adolescents between 14 and 18 years old and lumbar disceto-my after conservative treatment for 9 months. Indications for surgery were intractable pain and failure of conservative treatment for more than 6 weeks. Lumbar spine apophyseal ring fracture was found in 10 of t he 24 patients (42%) who had computed tomography studies. Seven patients had piecemeal excision of the fractured apophysis together with the discectomy. Results: All but three patients could raise their leg more than 70 degrees after then operation. The latest follow-up was conducted and average of 6.1 years after surgery. Good or excellent results were noted in 93% of the patients. Two patients had follow-up operations for recurrent disc herniation and would infection. Conclusion: Apophyseal ring fracture was a feature in adolescent disc herniation that that requires surgical intervention. Early computed tomography study is proposed to detect apophyseal ring lesion, which may lead to failure of conservative treatment. Excision of the fractured ring apophysis is suggested in addition to discectomy when the canal space is occupied. |
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