摘要
目的研究直腿抬高试验(straight leg raising test, SLR)结果与患者年龄、性别、病程、椎间盘突出率等因素之间的关系.方法对505例腰椎间盘突出病例的SLR影响因素进行逐步回归分析,男281例,女224例;年龄26～69岁,平均42.1岁.单间隙突出(L4-5或LsS1)337例,多间隙突出168例.321例行CT检查,184例行MR检查.结果SLR与急或慢性病程、椎间盘突出率、侧隐窝是否狭窄、椎间盘突出位置(中央型、侧旁型)、间歇性跛行距离等相关;而与年龄、性别、民族(汉族与维吾尔、哈萨克、回族比较)、椎间盘突出大小、单或多间隙突出、侧旁突出的根前、根腋、根肩型不相关;L4-5与L5S1椎间盘突出的SLR结果差异有非常显著性(P＜0.01).结论SLR受诸多因素影响,临床上不能将SLR结果作为判定椎间盘突出严重程度的重要指标.其相关因素为急或慢性病程、椎间盘突出率、侧隐窝是否狭窄、椎间盘突出位置及间歇性跛行距离.
Objective To retrospectively study the method of straight leg raising test and analyze multiple factors affecting straight leg raising test results. Methods There were total 505 patients with lumbar disc herniation recruited to this study. Of the 505 patients, 321 patients were scanned by CT, while another 184 patients were scanned by MR. The straight leg raising test and enhanced straight leg raising test (Bragard) were performed when the patient was positioned supinely. If radial pain or numbness occurred in lateral calf or dorsum of foot as straight leg was raised to certain degree, and then the straight leg raising test result was regarded as positive. If there was only low back pain or discomfort in popliteal fossa, the result of straight leg raising test was considered as negative. Positive enhanced straight leg raising test was defined as radial pain along sciatic nerve occurred when the foot was dorsally flexed as the straight leg was raised to highest degrees of straight leg raising test. Multiple factors affecting straight leg raising test results was carefully analyzed including patients' age, sex, disease onset time et al. Results The degree of straight leg raising test was significant correlated with the acute and chronic disease course, the rate of herniated disc, lateral recessus stenosis, the site of herniated disc (central type or lateral type) and walking distance of the intermittent claudication. There was no significant relationship with age, sex, nationality (Han versus Uigur, Kazak, Hui), the size of herniated disc, single or multiple levels of disc herniation, different subtypes of lateral disc herniation, central saggital diameter stenosis, the initial or recurred symptoms. With comparing the degree of straight leg raising test between L4-5 disc herniation and L5S1 disc herniation, there were significant differences in the test (P< 0.01). Conclusion The diagnosis of lumbar disc herniation can not only refer to SLR. Straight leg raising test is affected by multiple factors. Acute and chronic disease course, the extent of herniated disc, lateral recessus stenosis, the site of herniated disc and walking distance of the intermittent claudication are the factors significantly correlated with straight leg raising test results.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2003年第9期527-530,共4页
Chinese Journal of Orthopaedics
