极外侧型腰椎间盘突出症的诊治探讨  

The study on diagnosis and operative treatment of far lateral lumbar disc herniation

作　　者：杨启远[1] 罗小丽[1] 冯敬[1] 陈良[1] 范斌[1] 梁文杰[1] 赖显金[1] 冯志[1] 

机构地区：[1]绵阳市第三人民医院脊柱外科,四川绵阳621000

出　　处：《四川医学》2011年第7期1069-1071,共3页Sichuan Medical Journal

摘　　要：目的探讨极外侧型腰椎间盘突出症的诊断与治疗方法。方法回顾分析2005年1月~2009年12月收治25例极外侧型腰椎间盘突出症患者资料,其中椎间孔型17例,椎间孔外型8例。分别采用经椎板间扩大开窗入路,经峡部外缘入路两种术式进行手术治疗。结果全部患者随访6个月~5年,平均随访1年2个月。采用M acnab疗效评定标准,优19例,良5例,可1例,差无,优良率96%。结论极外侧型椎间盘突出症常累及相应节段的上位神经根,临床体征与影像学不符时应高度怀疑本症,运用CT薄层扫描和MR I检查可以确诊。保守治疗均不佳,应尽早行手术治疗。手术治疗应根据不同的突出部位选择不同手术方式。Objective To study the diagnosis and operative treatment of far lateral lumbar disc herniation.Methods The clilical data from 25 patients with far lateral lumbar disc herniation from January 2005 to December 2009 were retrospectively analyzed.In these cases,intraforaminal disc herniation in 17 cases were treated with the enlarged laminectomy approach,extraforaminal disc herniation in 8 cases were treated with the approach from the outer edge of par interarticularis.Results All the cases were followed up for 6 months to 5years with the average of 1 year and 2 months.According to the Macnab standard,the excellent and good rate was 96% with excellent in 19 cases,good in 5 cases,acceptable in 1 case and no poor case.Conclusion A far lateral lumbar disc herniation often involving the corresponding segments of the upper nerve root,clinical and medical imaging to be inconsistent with the high degree of suspicion,the use of CT scanning and MRI examination can be confirmed.Conservative treatment was not recommended,patients with far lateral lumbar disc herniation should be treated by different operations according to its types as soon as possible.

关 键 词：极外侧型 腰椎间盘突出症 诊断 手术治疗 

分 类 号：R687.3[医药卫生—骨科学]