Pathogenesis And Treatment Of Adolescent Calcified Lumbar Disc Herniation

Background:lumbar disc herniation is a common orthopaedic disease. In the westenit’s incidence is15.2%-30%and18%in domestic. elderly patients andheavy worker is the High-risk groups, male patients are more than female,and male female ratio is about4-12:1. Although the youngster has thehealthier disc than the elderly[1], frome recent reports, the prevalence ofyouth is rasied faster than before years. Daoyuan S[2]considerd it’sindence is1%-6%of adult and0.4%-1.3%of all the lumbar discherniation patient.[3][4][5]calcified lumbar disc herniation（CLDH）Specialtype of lumber disc herniation(LDH).[6][7]It is common in the clinicalwork but the adolescent calcified lumbar disc herniation (A CLDH)isinfrequent.In1924,Baron[8][9]frist named the “adolescent lumbar discherniation”by collecting the relevant cases.The calcified disc is morestiffness than the common disc,it is offen produce heavier clinicalsymptoms and signs.The cause of the A CLDH is not very clear, maybe itis associated with a variety of reasons. Conservative treatment is offenineffective,but the effect of surgical is very good.It is significant tochoose the appropriate operation methods.Purpose:lumbar disc herniation is a common orthopaedic disease. In recentyears, adolescent lumbar disc herniation is becoming to growth trend and the adolescent calcified lumbar disc herniation is the special type. It offenleads to the serious injury of dural sac and nerve root. It is significant tochoose the appropriate operation methods. This article through consultinga large number of literatures and retrospectively analyzed the case aboutA CLDH, Conclude the pathogenesis and treatment of A CLDH to Toguide clinical work.Method:There are112A LDH treated in our hospital from January2008toDecember2012. In all the112patients,there are18A CLDH wereconfirmed by CT, MRI,and Intraoperative pathologic. It include12male and6female patients.11to25years old,18years old on average.There are6at L4-5and12at L5S1. In all of them, only3patients werereceive conservative treatment, the others were under the surgery. Thisarticle try to analyze the pathologic and treatment method according tothe characteristics and the therapeutic effect.Result:(1)After the6months to4years follow-up visist, surgical effectassessment by JOA and Nakai, the excellent rate is86.7%.(2) Themarsupialization and MED has the same operation result assessented byJOA and Nakai,p>0.05.(3) All of the15patients received the surgicaltreatment maybe statistically significant accessented by the JOA andNakai,p<0.05.(4) The marsupialization and MED compared with the intraoperative blood soss,bed rest time,the time of postoperative and soon that has a significant difference by One-Samples Test,p<0.05.(5) Therecover percentage is about69.4%that is compared with preoperation.Conclusion:1.The pathologic and of A CLDH is closely related to the history oftrauma,the genetic and developmental abnormalities,the oligotrophiclumbar disc,self-protective reaction and so on.2.There is poor treatment who received Non-surgical treatment ofthe A CLDH.3. Classic operation is the effective surgical method to cure the ACLDH.4.MED is the effective surgical method to cure the A CLDH too.