腰椎间盘突出症合并症状性椎体血管瘤1例并文献复习  

Surgical treatment of patient with lumbar disc herniation and symptomatic vertebral hemangioma: a case report and literature review

作　　者：王奇[1] 费琦[1] 杨雍[1] 李东[1] 李锦军[1] 王炳强[1] 孟海[1] 苏楠[1] 林吉生[1] 

机构地区：[1]首都医科大学附属北京友谊医院骨科,北京100050

出　　处：《临床和实验医学杂志》2015年第17期1485-1487,共3页Journal of Clinical and Experimental Medicine

基　　金：首都医科大学基础-临床科研合作课题(13JL37)

摘　　要：目的探讨腰椎间盘突出症伴症状性椎体血管瘤的手术治疗效果。方法回顾性分析1例临床诊断明确的腰椎间盘突出症(L3-4)、腰椎管狭窄症(L4-5)伴多发性椎体血管瘤(其中L5血管瘤有临床症状)患者的临床表现、实验室和辅助检查结果及诊断与手术经过,并结合文献讨论其手术方法的选择和初步疗效。结果患者经积极术前准备,行"后路腰椎管减压(L3-5)、L3-4椎间盘摘除、椎弓根螺钉固定、椎间植骨(L3-4)+后外侧植骨(L4-5)融合术(L5椎体用一对骨水泥强化椎弓根螺钉)"治疗,配合围术期药物和康复锻炼后患者完全康复,无手术并发症。结论对于需手术治疗的腰椎间盘突出症合并症状性椎体血管瘤患者,可在充分减压、常规脊柱融合的同时对有症状的椎体血管瘤采用骨水泥强化椎弓根螺钉辅助手术治疗。Objective To analyze the clinical effects of surgical treatment for the patient with lumbar disc herniation and symptomatic ver-tebral hemangioma( SVH). Methods The clinical manifestation,diagnosis and surgical management of a patient with lumbar disc herniation( L3-4 ),lumbar spinal stenosis( L4-5 )and SVH( L5 )were retrospectively analyzed. The clinical effect was evaluated and surgical methods were discussed by a literature review. Results The patient underwent posterior decompression( L3-5 ),diskectomy( L3-4 ),posterior intervertebral fusion( L3-4 )and posterolateral fusion( L4-5 )with pedical screws system. Two cement-augmented pedical screws were used at both sides of L5 vertebra. The follow-up showed the satisfied clinical and radiological results were achieved. Conclusion For the patient with lumbar disc herni-ation and SVH at fusion levels,the use of cement-augmented pedical screws at the same time of complete decompression and spinal fusion may help achieving satisfied clinical effects.

关 键 词：腰椎 椎间盘突出 血管瘤 手术 

分 类 号：R687.3[医药卫生—骨科学]