腰骶椎后缘骺环骨折是青少年腰腿痛不可忽视的因素

　　摘要：为探讨青少年腰腿痛的病因病理特点，对观察组67例青少年腰腿痛患者和97例同期成年和老年病人的X片、CT、MRI及手术所见摘除物病理检查进行了对照比较。结果：发现腰骶椎后缘骺环骨折占少年腰腿痛患者的40.74%(11/27)，占青年腰腿痛患者的22.50%(9/40)；而具有相似征象者在成年对照组中仅占3.85%(2/52)，在老年对照组中仅占4.44%(2/47)，观察组与两对照组间有显著性差异(P＜0.01)，两观察组间和两对照组间差异则无显著性(P＞0.05)。结论：提示椎体后缘骺环骨折是青少年腰腿痛患者特有的病理改变，由此认为腰骶椎后缘骺环骨折是导致青少年腰腿痛不可忽视的因素之一。

Back Epiphysis Loop Fracture of Lumbosacral Vertebrae Is

　　An Important Cause of Adolescent Lumbocrural Pain

　　Abstract: To investigate the etiological and pathological characteristics of adolescent lumbocrural pain, the findings of X ray, CT and MRI and biopsy in 67 cases of adolescent (14～28 years old) and 97 of the adult and the aged were compared. The results showed that the incidence of back epiphysis loop fracture of lumbosacral vertebrae was 40.74% (12/27) and 22.50% (9/40) in the teenage (14～18) and the youth (19～28) respectively, and 3.85% (2/52) and 4.44% (2/47) in the adult(28～60) and the aged (over 60) respectively, showing that the differences were significant between the adolescent and the adult(P＜0.01) but not significant between the teenage and the youth as well as the adult&nb sp;and the aged (P＞0.05). It is indicated that back epiphysis loop fracture of lumbosacral vertebrae is the specific pathological feature of adolescent lumbocrural pain. Therefore, it should be regarded as an important cause of adolescent lumbocrural pain.

　　Key words:BACKACHE/etiology;　LUMBAR VERTEBRAE/injuries;@BACK EPIPHYSIS LOOP FRACTURE OF VERTEBRAE;　ADOLESCENCE

　　青少年腰腿痛，除腰椎间盘突出症所致外，还与其他很多因素有关。通过对本校第一附属医院一骨科自1995年1月～1999年5月收治的共67例14～28岁腰腿痛患者的分析，发现腰骶椎后缘骺环骨折是导致青少年腰腿痛的不可忽视的因素，报告如下。

　　1　临床资料

　　本组共收治青少年腰腿痛患者67例作为观察组，与同期住院的28岁以上成年及老年患者共97例形成对照，所有病例均来自本校第一附属医院一骨科住院病人。

　　1.1　观察组　分为少年组及青年组。其中少年组27例，男25例，女2例；年龄14～18岁，平均16.2岁；病程10天～2年，平均5.7月；有明显外伤史者18例，占66.67%。青年组40例，男29例，女11例；年龄19～28岁，平均24.7岁；病程1天～10年，平均17月；有明显外伤史者18例，占45%。

　　1.2　

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