硬膜内腰椎间盘突出症(附6例报告)  

Intradural Lumbar Disc Herniation——A Report of Six Cases

作　　者：路继科[1] 欧阳甲[1] 张江晖[1] 米吉提[1] 李玉军[1] 

机构地区：[1]新疆医学院第一附属医院骨科

出　　处：《新疆医学院学报》1992年第4期253-256,共4页

摘　　要：硬膜内腰椎间盘突出症临床上少见,术前诊断困难。本文报告6例,其中5例发生于L_(4-5),1例L_(3-4)。6例中2例有椎间盘手术史。术中均发现腹侧硬膜与后纵韧带紧密粘连、无法分离。水溶性非离子碘造影剂脊髓造影显示位于椎间隙平面的全梗阻、不全梗阻(本组各3例),根据梗阻断端边缘不规则或呈毛刷状。且有梗阻头、尾侧的硬膜囊前间隙增宽的特点,即可明确诊断。CTM(脊髓造影CT扫描)于梗阻部位扫描,能显示突出物与硬膜、蛛网膜下腔、神经根等的关系。本组5例术前已明确诊断,可能与水溶性造影剂脊髓造影及CTM联合应用有关。硬膜内突出一经确诊,应尽早手术,手术效果满意。Intradural lumbar dise herniation (ILDH) is rare and its preoperative diagnosis is difficult. There were five cases of ILDH at L_(4-5) level, one case at L_(3-4) level. Two of six cases received previous lumbar disc surgery at L_3-4 and L4-5 respectively. All cases were found to have adhesions between ventral wall of the dura(VWD) and posterior longitudinal ligament (PLL) at operation. Water—soluble contrast agent, myelography showed that the majority of ILDH patients have had an irregularly marginated defects or complete block, and the widenning of the anterior space between VWD and PLL. CTM may best confirm the presence of ILDH material in some cases. As soon as ILDH is diagnosed or suspected a prompt surgical decompression is an absolute requirement. The results of operation were generally favorable as long as the surgical procedures were carefully managed.

关 键 词：硬膜内 椎间盘突出 脊髓造影 

分 类 号：R681.53[医药卫生—骨科学]