椎管内游离型腰椎间盘突出症的诊断及术式探讨  

Diagnosis and Exploration of Operative Techniques of Intraspinal Sequestered Lumbar Disc Herniation

作　　者：张海波 张培勋 白美玲 张树桧[2] 

机构地区：[1]河南省开封市第一人民医院骨科,475000 [2]郑州大学第二附属医院骨科

出　　处：《骨与关节损伤杂志》2004年第5期297-299,共3页The Journal of Bone and Joint Injury

摘　　要：目的　分析总结椎管内游离型腰椎间盘突出症的临床特点及手术方式选择。方法　回顾性研究 4 7例椎管内游离型腰椎间盘突出症的临床及影像学表现、手术方式及随访结果。结果　平均随访 32个月 ,在伴有马尾神经损伤 1 2例中 ,除Ⅰa型 2例外 ,均有部分或完全恢复。根据Macnab标准评定 ,优良率为 93 6 %。结论　临床表现、理学检查和CT及MRI片对诊断有重要价值。改良椎板切除术式既术中暴露清晰、彻底摘除游离突出物和解除神经压迫 。Objective To analyze and determine the clinial features and operative techniques for the intraspinal sequestered lumbar disc herniation.Methods The clinical manifestations,imageology,operation techniques and follow-up results of the 47 patients with this disease were analyzed retrospectively.Results The patients were followed up for 32 months on average after operation,except 2 Ⅰa type cases,10 out of 12 patients with injury of cauda equina were recovered partially or completely.According to the Macnab standard,the excellent and good rate was 93 6%.Conclusion Clinical manifestations,systematic examination,CT and MRI films are valuable for the diagnosis of intraspinal sequestered lumbar disc herniation.The improved- laminectomy operation can not only give sufficient exposure during the operation,remove the osteophyte of migration completely and release the compression of nerve,but also protect the stability of bone structure of the lumbar spine too.

关 键 词：椎管 游离型腰椎间盘突出症 手术治疗 SLDH 临床资料 

分 类 号：R681.53[医药卫生—骨科学] R687.3[医药卫生—外科学]