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The Means of Clinical Screening in Make Differential Diagnosis between L4-L5 and L5-S1

Author: ZhangZhiQiang
Tutor: LiXiaoGuang
School: Taishan Medical College
Course: Surgery
Keywords: Lumbar disk herniation Physical examination of the spine Differential diagnosis
CLC: R681.53
Type: Master's thesis
Year: 2011
Downloads: 5
Quote: 0
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Abstract


Objective:Screen the clinical date of 234 cases of patients with lumbar disc herniation, whos mainly section is L4-L5 and L5-S1. Discuss and summarize the similarities and differences between two different segments in clinical signs and neural screenings, in order to make differential diagnosis just through clinical screening.Method:Screen the outpatients and the inpatients who were treated in Shandong Provincial Qianfoshan Hospital during April 2003 to December 2010, Require all the medical records are complete, correspond the diagnostic criteria and the Inclusion criteria, mainly section is L4-L5 or L5-S1, and have obvious clinical symptoms. According to Lumbar intervertebral disc segments, 234 cases of patients will be divided into the group of L4-5 and the group of L5-S1. 112 cases are concluded in the group L4-5, 122 cases are concluded in the group of L5-S1. Use Japanese Orthopaedic Association by the improved low back pain score standards (JOA Score) as the standard, observe and compare the similarities and differences between two groups of patients through the use of score and Clinical screening, from the experimental data with SPSS 13.0 statistical software package handling.Result:Through the test ofχ~2,we can see that: dysesthesia sellae and leg (on pain ,touching,temperature), decreased or disappeared ankle jerk on knee, positive squatting-down test on one foot, hight degree of straight leg raising test, the weaken of sphincter force have significant diffrerences (p<0.01) between two segments of lumbar disc herniation (L4-L5, L5-S1). Conclusion: Compared with L4-5 LDH, the characteristics of L5-S1 LDH were: dysesthesia sellae and leg (on pain,touching,temperature), decreased or disappeared ankle jerk on knee, positive squatting-down test on one foot, hight degree of straight leg raising test, the weaken of sphincter force etc. These characteristics can help us make differential diagnosis between different segments of lumbar disc herniation (L4-L5, L5-S1).

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CLC: > Medicine, health > Surgery > Orthopaedic Surgery ( movement system diseases,orthopedic surgery ) > Bone diseases > Spine and back disorders > Spinal joint disease
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