硬膜内腰椎间盘突出症1例的诊治及相关文献回顾分析  

A case report and review of relevant literature diagnosis and treatment of intradural lumbar disc herniation

作　　者：翟金帅 黄腾[1] 高博[1] 张隆[1] 魏景超[1] 李文毅[1] 李西成[1] ZHAI Jinshuai;HUANG Teng;GAO Bo;ZHANG Long;WEI Jingchao;LI Wenyi;LI Xicheng(Department of Orthopedics,Hebei General Hospital,Hebei Province,Shijiazhuang,051000,China)

机构地区：[1]河北省人民医院骨科,河北石家庄051000

出　　处：《中国医药导报》2022年第24期186-189,共4页China Medical Herald

基　　金：河北省医学科学研究重点课题计划项目(20180149)。

摘　　要：硬膜内型腰椎间盘突出症(ILDH)是一种罕见的疾病,其误诊率、漏诊率很高。由于突出椎间盘进入硬膜内,一旦误诊或漏诊,可能导致治疗效果不理想,甚至加重,给患者造成巨大的心理与经济负担。为提高临床对该疾病的诊疗水平,正确制订诊疗方案。本文分析探讨1例就诊于河北省人民医院骨科的硬膜内腰椎间盘突出症患者,该患者出现神经根受累症状和马尾综合征表现,通过术前查体、阅读影像学资料,考虑为ILDH,行腰椎后路开放手术治疗,取出疝入硬膜内的髓核组织,术后病理检查证实为ILDH,积极给予对症治疗,术后恢复良好。通过回顾性分析国内外文献,多数认为一旦确诊ILDH,应积极手术治疗;同时通过对疾病的症状、临床表现、影像特征、手术方式等进行文献复习,提高对该疾病的认识,进而以少误诊或漏诊。Intradural lumbar disc herniation(ILDH)is a rare disease with a high rate of misdiagnosis and missed diagnosis.As the herniated disc enters the dural,once misdiagnosed or missed diagnosis,the treatment effect may not be ideal,or even worse,causing huge psychological and economic burden to patients.In order to improve the clinical diagnosis and treatment level of this disease,the correct diagnosis and treatment plan was formulated.This paper analyzed and discussed a patient with ILDH admitted to the Department of Orthopedics of Hebei General People’s Hospital.The patient presented symptoms of nerve root involvement and cauda equina syndrome.Through preoperative physical examination and imaging data reading,the patient was considered as ILDH,posterior lumbar open surgery was performed to remove the nucleus pulposus tissue herniated into the dura,postoperative pathological examination confirmed ILDH,positive symptomatic treatment,good postoperative recovery.Based on the review and analysis of the domestic and foreign literature,most people believe that the diagnosis of ILDH should be actively treated by surgery;at the same time,literature review was carried out on the symptoms,clinical manifestations,imaging features and surgical methods of the disease to improve the understanding of the disease,so as to reduce misdiagnosis or missed diagnosis.

关 键 词：硬膜内 腰椎间盘突出 硬膜内腰椎间盘突出症 加速康复外科 病例报道 

分 类 号：R681[医药卫生—骨科学]