游离型腰椎间盘突出症的手术治疗  

The Surgical Treatment of the Sequested Lumbar Disc Herniation

作　　者：胡豇[1] 刘仲前[1] 王跃[1] 万仑[1] 唐六一[1] 张耀明[1] 

机构地区：[1]四川省医学科学院,四川省人民医院脊柱外科,四川成都610072

出　　处：《实用骨科杂志》2012年第5期391-393,共3页Journal of Practical Orthopaedics

摘　　要：目的评价游离髓核摘除术治疗游离型腰椎间盘突出症的疗效。方法 2003年1月至2009年12月采用游离髓核摘除术治疗游离型腰椎间盘突出症69例,获得完整随访资料者58例,其中男31例,女27例,年龄19～54岁,平均38.5岁。L3～4椎间盘突出3例,L4～5椎间盘突出29例,L5S1椎间盘突出26例。根据游离髓核的位置,分别采用扩大开窗、半椎板切除和全椎板切除,摘除游离髓核,研究其发病情况、临床症状、体征、影像学表现、手术方法、术中发现及治疗效果。结果随访时间1～6年,平均3.5年,平均手术时间(1.0±0.2)h,平均出血量(280±25)mL。硬脊膜撕破8例,一过性单侧神经根麻痹2例。末次随访复发2例,58例患者按Nakai标准评定疗效,优24例,良27例,可5例,差2例,优良率87.9%。结论彻底摘除游离髓核是治疗游离型椎间盘突出症的较好方法。Objective To evaluate the clinical efficacy of neucleus extraction for the sequested lumbar disc herniation.Methods 58 patients with sequested lumber disc herniation were treated surgically between Jan.2003-Dec.2009.There were 31 males and 27 females with average age of 38.5 years（range from19 to 54 years）.L3～4were involved in 3 cases,L4～5in 29 cases,L5S1in 26 cases.The patients were treated by window-open,semi-laminectomy,complete laminectomy respectively based on site of herniation.The duration,symptoms and signs,the radiology performance and the operation treatment result were discussed.Results All the patients were followed-up for an average of 3.5 years（range 1 to 6 years）.The surgery time was（1.0±0.2） hours and the bleeding was（280±25） mL.Complications included cerebrospinal fluid leakage in 6 cases,unilateral transient lower extremity paresthesia in 2 cases.According to Nakai Criterion,the result for the operative treatment was excellent in 24cases,good in 27 cases,fair in 5 cases,poor in 2 cases.The rate of excellent and good results was 87.9%.Conclusion The sequested neucleus extracted completely is a good method for the sequested lumbar disc herniation.

关 键 词：腰椎间盘突出症 游离髓核 临床疗效 手术治疗 

分 类 号：R681.53[医药卫生—骨科学]