腰椎间盘突出症合并骨化的临床特点与治疗  

Treatment and Clinical Characteristics of Calcified Lumber Herniation

作　　者：汤逊[1] 周田华[1] 林月秋[1] 阮默[1] 潘险峰[1] 刘力[1] 王娜[1] 

机构地区：[1]成都军区昆明总医院骨科,云南昆明650032

出　　处：《伤残医学杂志》2004年第2期9-11,共3页Medical Journal of Trauma and Disability

摘　　要：目的：探讨腰椎间盘突出症合并骨化的临床特点与治疗方法．方法：手术治疗腰椎间盘突出合并骨化104例，外侧型或推间孔型者，采用一侧椎板间开窗或扩大开窗：中央型及部分旁中央型，作两侧椎板间开窗；中央型和旁中央型合并椎管及侧隐患狭窄者，两侧椎板开窗并行桥式椎管潜行扩大，采用特制骨圆凿和“L”型骨刀切除骨化问盘．结果：104例经11个月～5年随访，优54例，良42例，可8例，优良率为92．1％．结论：腰椎间盘突出症合并骨化经短期保守治疗无效，应选择手术治疗．根据临床特点、CT、术中所见确定手术方法，特制骨圆凿和“L”型骨刀的应用可减少对脊椎稳定性的破坏，提高手术的安全性和有效性．Objective: To study the clinical characteristics and treatment method of lumber disc hemiation combined with calcification. Methods: 104 cases of calcified lumber disc hemiation were operated. Unilateral laminal fenestration or enlarged fenestration was done to the lateral type and foraminate type. Bilateral fenestration combined with bridged hiding vertebral canal enlargement to central and part of paracentral type accompanied with stenosis of central type and lateral canal. The specified chisel and 'L' shaped osteotome were used to cut the calcified hemiated disc. Results: After 11 months to 5 years follow-up, 54 cases got excellent result, good in 42, improved in 8 cases, and the good-excellent rate was 92.1%. Conclusion: Operation should be done after a short-termed non-effective conservative treatment The operative method should be determined by clinical manifestation, CT image and the condition in operation. The usage of the specified chisel and osteotome could decrease operation destruction to vertebral stability and improve the safety and effectiveness of operation.

关 键 词：腰椎问盘突出症 骨化 神经根 神经组织 

分 类 号：R681.53[医药卫生—骨科学]