神経根症状を伴う腰痛症(腰肢痛症)のCT所見 ― 腰椎椎間板ヘルニアの手術適応との関連で ―

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We evaluated 190 patients with disc space explorations for the treatment of back pain and radiculopathy. In detailed evaluation of 144 patients with CT-diagnosed herniated nucleus pulposus(HNP), these HNPs were classified by location, extrusion. If the maximum anteroposterior diameter was less than one-third of the anticipated normal sagittal diameter of the dural sac, we classified it as Grade I , and if more than two-third, we classified it as Grade III, and intermediate size of HNP was clssified as Grade II. Seventy-five cases were located in L4/5 and 57 cases in L5/S1. And central extrusion was noted in 38.3%, central-lateral in 47.7%, lateral in 7.2%, and extreme lateral in 6.5%. The operative rate was as follows ; 7.3% (4/55) in G.I, 61.9% (39/63) in G.II, 96% (24/25) in G.III, and 40% (4/10) in G .X. Computed tomography (CT) is an accurate method of diagnosing HNP in patients with back pain and radiculopathy. And if CT reveals G.M finding, emergent surgical therapy will be indicated in that case, and the conservative therapy will be indicated in G.I HNP.
1990-08-01