The Diagnosis And Treatment Of Ruptured Lumbar Intervertebral Disc Herniation

Objective:To provide evidence for the diagnosis of ruptured lumbar disc herniation by analyzing the risk factors, symptoms, signs and imaging findings and to explore the treatment of RLDH.Methods:The risk factors, symptoms, signs and imaging findings of the 24 patients surgically confirmed of ruptured lumbar disc herniation were retrospectivly analyzed and surgeries were operated on all 24 patients. The nucleus protrusion rate(NRP) was calculated according to Bernkardt'S research and the posterior angle of herniation was measured on CT or MRI films.Results:There were 18 cases whose NPR wre more than 30% and 15 cases whose posterior angle of herniation were less than 90 degree. And the diagnostic accuracy was 75% and 62.5% respectively。The 24 RLDH cases were classified into 3 groups:9 cases in trans-posterior-longitudinal-ligament group,13 cases in the the post-posterior-longitudinal-ligament group, and 2 cases in the intra-nerve-fiber-membrane group. According to Nakai evaluation criteria,20 cases were excellent,3 cases were good,1 case was moderate, and the rate of fineness was 95.83%.Conclusion:The RLDH was classified into 3 groups:the trans-posterior-longitudinal-ligament group, the post-posterior-longitudinal-ligament group, and the intra-nerve-fiber-membrane group. The clinical classification can provide important reference for the diagnosis, the choose of surgical treatment and operation of RLDH.