腰椎间盘突出症术后医源性并发症CT脊髓造影跟踪观察80例报告  

Tracking View of CT Myelograhy following Iatrogenic Complications of Lumbar Discoidectomy A Report of 80 Cases

作　　者：黄胜堂 邵振海 靳安民[1,2] 曾盛 舒小秋[1,2] 

机构地区：[1]空军第454医院 [2]第一军医大学珠江医院全军医学骨科中心

出　　处：《颈腰痛杂志》1999年第2期95-96,共2页The Journal of Cervicodynia and Lumbodynia

摘　　要：方法：笔者对８０例半椎板全椎板切除术后患者，进行３个月、６个月、１２个月ＣＴ脊髓造影跟踪观察。结果：认为医源性并发症是———椎管生理解剖缺失、有效防粘连受损，椎管外软组织凸入椎管内与硬脊膜神经根粘连形成纤维化、硬脊膜外疤痕挛缩，继发椎管狭窄。术后半年ＣＴ硬脊膜外纤维化密度阴影加重占腰腿痛组２７３％、脊髓造影，硬脊膜疤痕挛缩神经根袖充盈缺损加重２０４５％。结论：因而术中尽量保持椎管完整，减少硬脊膜外纤维化程度，提高手术率有直接意义。Methods:Eighty cases of total or hemi laminectomy of lumbar spine were checked up by CT myelography in 3、6 and 12 months after the operations.Results:The results of the CT myelography's view showed iatrogenic complications including spinal canal structure defect,antiadhesive destroy of spinal canal,extending of epidural tissues into the canal,root's adhesion and epidural scar contraction with secondary spinal canal stenosis.The shade of epidural fibrosis in the CT presented in 27.3% and that of root fibrosis in the myelography in 20.45%.Conclusions:Authors think that lumbar vertebral procedures should be performed with keeping vertebral intact,minor damage of spinal tissues and the limited extent of operative exposure.

关 键 词：腰椎间盘突出 术后并发症 CT 脊髓造影 医源性 

分 类 号：R681.530.4[医药卫生—骨科学] R816.8[医药卫生—外科学]