硬膜内型腰椎间盘突出症:2例报告和综述  

Intradural lumbar disc herniation:2-case report with literature review

作　　者：杨义 李代君[1] 蔡玉强 蔡小军[1] YANG Yi;LI Dai-jun;CAI Yu-qiang;CAI Xiaojun(Department of Spinal Surgery,The First People's Hospital of Zunyi City,Zunyi,Guizhou 563000,China;Department of Orthope-dics,Affiliated Hospital,Zunyi Medical University,Zunyi,Guizhou 563000,China)

机构地区：[1]遵义市第一人民医院脊柱外科,贵州遵义563000 [2]遵义医科大学附属医院骨科,贵州遵义563000

出　　处：《中国矫形外科杂志》2025年第2期149-155,共7页Orthopedic Journal of China

基　　金：遵义市科技计划项目[编号:遵市科合HZ字(2022)46号];贵州省社会攻关项目[编号:黔科合SY字(2015)3036]。

摘　　要：硬膜内椎间盘突出(intradural lumbar disc herniation,IDH)是一种罕见疾病,其诊断易与椎管内肿瘤混淆。MRI在临床诊断中发挥关键作用,有助于术前鉴别诊断。本文报道了2例病例,均为男性,年龄分别为52、60岁,涉及L4/5节段。病例1影像显示硬脊膜和纤维环破裂,而病例2术前误诊为肿瘤,最终证实为IDH,2例患者经手术治疗后恢复良好,无严重并发症。本文通过国内外文献回顾,讨论了IDH的治疗策略,包括显微镜、微创技术发展及其在手术中的应用,旨在提升对IDH诊断和治疗的认识,为临床医生诊断治疗该疾病提供借鉴。Intradural lumbar disc herniation(IDH)is a rare condition,and its diagnosis is often confused with intraspinal tumors.MRIplays a key role in clinical diagnosis and helps in preoperative differential diagnosis.We report two cases,both male,aged 52 and 60 years,involving L4/5 segments.The imaging of case 1 showed rupture of the dura and annulus fibrosa,while case 2 was misdiagnosed as a tumor be-fore surgery and eventually proved to be IDH.The two patients recovered well after surgical treatment without serious complications.Basedon the review of domestic and foreign literature,this paper discusses the treatment strategies of IDH,including the development of micro-scopes and minimally invasive techniques and their application in surgery,aiming to improve the understanding of diagnosis and treatmentof IDH,and provide references for clinicians to diagnose and treat this disease.

关 键 词：硬膜内椎间盘突出 微创手术 马尾综合征 

分 类 号：R681.53[医药卫生—骨科学]