高位腰椎间盘突出症手术治疗23例报告  

Surgical treatment for upper lumbar disc herniation:a report of 23 cases

作　　者：郭乐斌[1,2] 卓小为 倪松 

机构地区：[1]湖南益阳市中心医院 [2]中南大学湘雅医学院第四临床学院骨一科,湖南益阳413000

出　　处：《颈腰痛杂志》2011年第1期32-33,共2页The Journal of Cervicodynia and Lumbodynia

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。方法对23例高位腰椎间盘突出症患者采用两种手术方法治疗:对于8例以一侧症状为主者,行单侧椎板间隙开窗或半椎板切除,髓核摘除;对于15例髓核突出大或中央型突出合并双侧症状、出现马尾综合征者,行全椎板切除、髓核摘除、后路植骨融合内固定术。结果术后随访1～15年,平均3年9个月,优14例,良7例,差2例,优良率91.3%。结论高位腰椎间盘突出症临床表现复杂,神经损害较重,误漏诊率高,应早期手术解除压迫及恢复脊柱的稳定性。Objective To explore the clinical characteristics,diagnosis and treatment method of upper lumbar disc herniation.Methods 23 cases of upper lumbar disc herniation were treated with two different surgical methods：unilateral fenestration or semi-laminectomy and nucleus pulposus excision in 8 cases with unilateral symptom;laminectomy,nucleus pulposus excision and posterior bone graft and internal fixation in 15 cases of big or central disc herniation with bilateral symptom or cauda equina syndrome.Results 23 cases were followed up for 1 to 15 years（mean 3 years and 9 months）postoperatively,14 rated as excellent,7 as good and 2 as poor.The rate of excellent and good results was 91.3%.Conclusion The clinical manifestation of upper lumbar disc herniation is complicated,the lesion of nerve is relatively servere and misdiagnosis rate is high,early decompression and reconstruction of spinal stability is the key of treatment.

关 键 词：高位腰椎间盘突出症 手术治疗 

分 类 号：R681.53[医药卫生—骨科学]