摘要
目的探讨高位腰椎间盘突出症的临床特点、诊断及治疗方法。方法60例高位腰椎间盘突出症患者中,15例行全椎板减压髓核摘除内固定,8例行半椎板减压髓核摘除,7例行双侧开窗髓核摘除,3例行经峡部外缘入路髓核摘除,27例行单侧开窗髓核摘除(其中神经根管扩大6例)。结果60例均获随访,时间6～36个月。术中硬脊膜破裂脑脊液漏3例,无神经损伤病例出现。参考陆裕朴疗效评定标准:优50例,良8例,可2例,优良率96.7%。结论高位腰椎间盘突出症的临床表现复杂,应根据临床查体结合影像学检查选择手术入路。对于年轻、单节段及旁侧型的椎间盘突出症者选择单侧开窗或半椎板减压髓核摘除;对多间隙、中央型突出髓核大者选择双侧开窗或全椎板减压髓核摘除加内固定。
Objective To explore the clinical characteristics,diagnosis and treatment methods of upper lumbar disc herniation. Methods All patients were treated by surgical treatment,laminectomy and internal fixation in 15 cases,semi-laminectomy in 8 cases,bilateral fenestration in 7 cases,the approach of outer edge of pars interarticularis in 3 cases and unilateral fenestration in 27 cases,of which 6 case nerve root canal were expanded. Results All patients were followed up for 636 months. 3 cases were complicated with leakage of cerebrospinal fluid. No nerve injury was found. The results were excellent in 50 cases,good in 8 and fair in 2. The excellent and good rate was 96.7%. Conclusions The clinical manifestations of upper lumbar disc herniation are complicated. The approach of operation should be determined by physical and radiographic examination： unilateral fenestration or semi-laminectomy for the young,single intervertebral space and side-hernia;bilateral fenestration or laminectomy and internal fixation for multi-intervertebral space,central-hernia and the intervertebral space of huge nucleus pulposus.
出处
《临床骨科杂志》
2009年第4期377-379,共3页
Journal of Clinical Orthopaedics
关键词
腰椎间盘突出症
椎板减压
lumbar disc herniation
decompression laminectomy
