侧后方入路手术治疗高位腰椎间盘突出症

目的:探讨侧后方入路手术治疗高位腰椎间盘突出症的效果和适应证。方法:腰椎间盘突出症患者27例,男16例,女11例;年龄18～61岁,平均35.6岁。单节段突出23例:L1,26例、L2,312例、L3,45例,多节段突出4例:L1,2 L4,51例、L2,3 L3,42例、L3,4 L4,51例所有病例均采用侧后方入路手术,直接摘除压迫脊髓前方的间盘组织、骨增生组织,如椎间盘不稳,则行椎间植骨融合、内固定治疗。结果:所有病例获得随访,随访时间12～53个月,平均29个月。根据Otani等分级方法评定疗效:优13例,良10例,进步4例。结论:侧后方入路手术是一种治疗高位腰椎间盘突出症的良好方法,临床应用时要掌握好其适应证。

Operative treatment of lumbar intervertebral disc herniation in upper segments through posterior-lateral approach

Objective:To explore clinical effect and indications of posterior-lateral approach operation for lumbar intervertebral disc herniation in upper segments.Methods:Twenty-seven patients with lumbar intervertebral disc herniation,16 cases were male and 11 cases were female with an average age of 35.6 years(rang from 18 to 61).Single segment disc herniation was 23 cases:L1,2 6 cases,L2,3 12 cases,L3,4 5 cases.Multi-segment disc herniation was 4 cases:L1,2 L4,5 1 case,L2,3 L3,4 2 case,L3,4 L4,5 1 case.All cases were treated through posterior-lateral approach to excise intervertebral disc and osteophytes.Some patients with lumbar instablility were treated with antogenous-grafting and internal fixation.Results:All the patients were followed up 12-53 months with an average of 29 months.According to Otani's classification the result was excellent in 13 cases,good in 10,advance in 4.Conclusion:Surgical treatment through posterior-lateral approach is a good method for lumbar intervertebral disc herniation in upper segments.Proper indication is important in clinical application.