CAJ | 학술논문

目的：研究突出椎间盘自然吸收的现象，为腰椎间盘突出症的非手术或手术治疗选择提供依据。方法对18例发生突出椎间盘自然吸收现象患者的病程、症状、体征及影像学资料进行回顾性分析。结果所有患者均为破碎型突出。18例均获随访，时间6~72(17±15)个月。突出物吸收率：完全消失12例，显著缩小6例。其中1例后纵韧带破裂者遗留少许腰痛，跟腱反射未恢复，但能正常工作及生活；另有1例腰腿痛复发，影像学显示突出间盘缩小后再次大块脱出，后纵韧带破裂；其余患者症状体征完全恢复，腰椎主动活动自如。结论腰椎间盘突出症如果后纵韧带完整，即使突出物巨大，症状重，只要没有马尾综合征或进行性单根神经根麻痹，都可以进行非手术治疗，且预后良好；但椎间盘吸收后在合适的条件下可再次突出。
목적：연구돌출추간반자연흡수적현상，위요추간반돌출증적비수술혹수술치료선택제공의거。방법대18례발생돌출추간반자연흡수현상환자적병정、증상、체정급영상학자료진행회고성분석。결과소유환자균위파쇄형돌출。18례균획수방，시간6~72(17±15)개월。돌출물흡수솔：완전소실12례，현저축소6례。기중1례후종인대파렬자유류소허요통，근건반사미회복，단능정상공작급생활；령유1례요퇴통복발，영상학현시돌출간반축소후재차대괴탈출，후종인대파렬；기여환자증상체정완전회복，요추주동활동자여。결론요추간반돌출증여과후종인대완정，즉사돌출물거대，증상중，지요몰유마미종합정혹진행성단근신경근마비，도가이진행비수술치료，차예후량호；단추간반흡수후재합괄적조건하가재차돌출。
Objective In order to provide identifiable ground for surgical or nonoperative treatment for lumbar disc herniation, the phenomenon of spontaneous resolution of the herniation was studied. Methods 18 subjects whose herniation was absorbed were enrolled, their natural history, symptom, sign and image datas were analyzed. Results All the cases were extrusion, at a follow-up of 6~72 (17 ± 15)months. The herniated discs disappeared in 12 ca-ses, 6 cases had a reduction of more than 50%. Posterior longitudinal ligament was torn in one case, mildly low back pain was remained and Achilles tendon reflex did not recovered, but the patient could work normally. Another case suffered a relapse of severe sciatica, MRI scans showed the disc extruded again, and posterior longitudinal ligament was torn. The remaining patients showed excellent results. Conclusions When the posterior longitudinal ligament is in integrity, no signs of ingravescent never damage or cauda equina syndrome, which can adopt a conservative treat-ment policy, even if herniated disc is enormous and sciatica is severe, and the result is good. However, the disc may herniate again.