腰椎管侧隐窝狭窄症  

THE STENOSIS OF LUMBAR LATERAL RECESS

作　　者：周秉文[1] 胡有谷[1] 

机构地区：[1]青岛医学院附院骨科

出　　处：《青岛医学院学报》1990年第3期192-196,共5页Acta Academiae Medicinae Qingdao Universitatis

摘　　要：24例经手术治疗的腰椎管侧隐窝狭窄症患者,男19例,女5例;年龄26～77岁,平均47.7岁.临床表现皆有腰痛和(或)腿麻痛,21例有进行性间歇性跛行,3例伴有咳嗽时腿痛加重.痛觉、运动及反射障碍均出现在L_5或S_1的神经支配区.X线平片表现为不同程度的椎间隙狭窄,椎体缘增生,椎弓根上切迹短及上关节缘内移;碘水髓腔造影,可见神经根袖中断;CT示侧隐窝狭窄甚至闭塞.24例皆行半椎板切除或椎板间隙扩大开窗神经根减压术,术后短期内症状消失13例,减轻10例,1例无明显改进.作者重点明确了侧隐窝的解剖概念,并结合文献对该症的发病机制、临床表现及其诊断、治疗进行了讨论,认为CT检查有益于疑难病例的确诊.Twenty-four patients(19 men and 5 women), 26～77 years old (averaging 47.7 years),suffering from stenosis of the lateral recess confirmed by surgery,were studied retrospectively.All of them had low-back pain and/or leg pain and paresthesia,21 had progressing neurological intermittent claudication, and 3 had increased pain at coughing. The pain and defects of motion and reflex disturbances occurred at the disfributing region of L_5 and S_1. Radiographic changes were narrowing of intervertebral space osteophyte formation,shortening of the A-P diameter of the upper pedicle notch, and midmigrating of the upper facet. Myelography showed block of nerve root sheath, and CT showed stenosis or blockage of the lateral recess. The main procedure of treatment was semilaminectomy and nerve root decompression. The results were: 13 cases were relieved of their symptoms soon after surgery, 10 were improved,and one remained unchanged. In discussion emphasis was focused on the anatomical of concept of recess. The factors causing stenosis,clinical features, diagnosis and treatment were also discussed with review of the literature. The authors believe that CT is very useful for the confirmation of uncertain cases.

关 键 词：腰椎管狭窄 侧隐窝狭窄 解剖 手术 

分 类 号：R681.53[医药卫生—骨科学]