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首页> 外文期刊>Spine >Symptoms of thoracolumbar junction disc herniation.
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Symptoms of thoracolumbar junction disc herniation.

机译：胸腰椎间盘突出症的症状。

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摘要

STUDY DESIGN: A retrospective clinical review of patients with thoracolumbar junction disc herniation. OBJECTIVES: To evaluate the clinical features of thoracolumbar junction disc herniation and to prepare a chart for the level diagnosis in the neurologic findings and symptoms. SUMMARY OF BACKGROUND DATA: Thoracolumbar junction disc herniations show a variety of signs and symptoms because of the complexity of the upper and lower neurons of the spinal cord, cauda equina, and nerve roots. Furthermore, much is still unknown about thoracolumbar junction disc herniations because of their rare frequency. METHODS: The clinical features of 26 patients who had undergone operations for single disc herniations at T10-T11 through L2-L3 were investigated. Affected levels were as follows: 2 patients with disc herniation at T10-T11 disc, 4 patients at T11-T12, 3 patients at T12-L1, 6 patients at L1-L2, and 11 patients at L2-L3. The level of disc space of interest was confirmed with whole-spine plain roentgenograms. The caudal end of the cord was judged by magnetic resonance imaging and computed tomographic myelogram. RESULTS: Two patients with T10-T11 disc herniation showed moderate lower extremity weakness, increased patellar tendon reflex, and sensory disturbance of the entire lower extremities. Three of four patients with T11-T12 disc herniation experienced lower extremity weakness, and three patients had accentuated patellar tendon reflex. Sensory disturbance was observed in the anterolateral aspect of the thigh in one patient and on the entire leg in three patients. Bowel and bladder dysfunction was noted in three patients. In the T12-L1 disc herniation group (n = 3), muscle weakness and atrophy below the leg were advanced, and bowel and bladder dysfunction were also noted. Two of these three patients had bilateral drop foot, and one patient had unilateral drop foot; sensory disturbance was noted in the sole or foot and around the circumference of the anus, and the patellar tendon reflex and Achilles tendon reflex were absent. All six patients with L1-L2 disc herniation showed severe thigh pain and sensory disturbance at the anterior aspect or lateral aspect of the thigh. On the other hand, there were no clear signs of lower extremity weakness, muscle atrophy, deep tendon reflex, or bowel and bladder dysfunction in these patients. In the L2-L3 disc herniation group (n = 11), all patients had severe thigh pain and sensory disturbance of the anterior aspect or the lateral aspect of the thigh. Weakness in the quadriceps was noted in five patients and weakness in the tibialis anterior in two patients. Decreased or absence of patellar tendon reflex was observed in nine patients. Five patients had positive straight leg raising test results, and eight patients showed positive femoral nerve stretch test results. CONCLUSION: Among thoracolumbar junction disc herniations, T10-T11 and T11-T12 disc herniations were considered upper neuron disorders, T12-L1 disc herniations were considered lower neuron disorders, L1-L2 disc herniations were considered mild disorders of the cauda equina and radiculopathy, and L2-L3 disc herniations were considered radiculopathy. These findings had relatively distinct differences among herniated disc levels.
机译：研究设计：胸腰椎间盘突出症患者的回顾性临床回顾。目的：评价胸腰交界椎间盘突出症的临床特征，并为神经系统发现和症状的水平诊断准备图表。背景数据摘要：由于脊髓，马尾神经和神经根的上，下神经元的复杂性，胸腰椎间盘突出症表现出各种体征和症状。此外，由于胸腰椎间盘突出症的发生频率较低，因此尚不清楚。方法：调查26例在T10-T11至L2-L3期间接受过单椎间盘突出手术的患者的临床特征。受影响的水平如下：2例T10-T11椎间盘突出症患者，4例T11-T12椎间盘突出症，3例T12-L1患者，6例L1-L2患者和11例L2-L3患者。感兴趣的椎间盘间隙的水平已通过全脊柱X线平片证实。脊髓的尾端通过磁共振成像和计算机断层扫描脊髓造影进行判断。结果：2例T10-T11椎间盘突出症患者表现出中度下肢无力，pa腱反射增高以及整个下肢的感觉障碍。 T11-T12椎间盘突出症的四位患者中有三位出现下肢无力，三位患者的pa骨腱反射加重。在一名患者的大腿前外侧和三名患者的整个腿部均观察到感觉障碍。注意到三名患者的肠和膀胱功能障碍。在T12-L1椎间盘突出症组（n = 3）中，腿下方的肌肉无力和萎缩恶化，并且还注意到肠和膀胱功能障碍。这三名患者中有两名患有双侧下肢脚，一名患者有单侧下肢脚。在足底或足以及肛门周围发现了感觉障碍，并且the骨腱反射和跟腱反射缺失。所有六名L1-L2椎间盘突出症患者均在大腿前部或外侧表现出严重的大腿疼痛和感觉障碍。另一方面，在这些患者中，没有明显的下肢无力，肌肉萎缩，深腱反射或肠和膀胱功能障碍的迹象。在L2-L3椎间盘突出症组（n = 11）中，所有患者均患有严重的大腿疼痛，并且对大腿的前部或外侧有感觉障碍。五名患者出现四头肌无力，两名患者出现胫前肌无力。 9例患者观察到pa腱反射减弱或不存在。五名患者的直腿抬高测试结果为阳性，八名患者的股神经拉伸测试结果为阳性。结论：在胸腰交界椎间盘突出症中，T10-T11和T11-T12椎间盘突出症被认为是上神经元疾病，T12-L1椎间盘突出症被认为是下神经元疾病，L1-L2椎间盘突出症被认为是马尾神经痛和神经根疾病的轻度疾病， L2-L3椎间盘突出症被认为是神经根病。这些发现在椎间盘突出症水平之间具有相对明显的差异。

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