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王某,男.34岁。因腰部伴右下肢疼痛2年加重半月来诊,2年前因感受风寒后出现,腰部及有下肢疼痛,经拔罐疗法后症状减轻。半月前因弯腰搬重物.用力不当。致腰痛加重.右下肢疼痛加重,咳嗽、喷嚏及捧便时症状加重。查:腰椎生理曲度消失,向右侧弯畸形,L4/5。L5/S1右侧棘突旁压痛(+)。且向右小腿后侧及踝部放射.直腿抬高试验右30°(+)。加强(+).右小腿外侧及足外侧皮肤感觉迟钝,右侧拇背伸肌力较左侧减弱,右侧跟腱反射未引出,病理征未引出,舌暗红、台白,脉弦。X线:腰椎生理曲度稍直。略向右侧弯,L4/5.L5/Sl椎间隙变窄.CT:L4/5均匀膨出。L5/SL向右侧突出.相应神经根受压。要求写出:诊断、辩证、主要鉴别诊断及非手术治疗方案。

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