手术治疗腰椎间盘突出并椎体后缘离断症

目的探讨腰椎间盘突出并椎体后缘离断症的病理改变及影像学诊断依据，提出治疗原则及手术要点。方法对收治的腰腿痛患者进行CT检查，确诊病例不宜牵引推拿治疗。手术采用双侧椎板开窗术式，切尽病变间隙的游离骨块及椎间盘，术后3周戴腰围下地。结果12例患者全部手术治疗，术后疼痛消失。随访1～9年，5例于阴雨天或过劳后腰部有轻微酸痛。1例于术后6年时出现对侧小腿胀痛，无进行性加重。结论腰椎间盘突出并椎体后缘离断症，CT检查最有价值，不宜进行牵引推拿治疗，双侧椎板开窗术式是疗效确切的方法之一。

The Treatment of the Lumbar Disk Herniation Associated with Posterior Bony Edge Separation by Surgery

Objective To study the pathological changes and imaging diagnosis basis of lumbar disk herniation associated with posterior bony edge separation,raise the principles of treatment and the key points of operation. Methods The patients whose lumber and leg pained should be tested by CT,the cases which be diagnosed should not be treated by traction and massage. The surgery adopts bilateral laminectomy fenestration,cutting all the free bone mass and intervertebral disk in the lesions gap,patients can walk on the ground with waist three weeks after operation. Results The 12 patients were all treated by surgery and the pain disappeared after operation. We had interviewed them for 1-9 years,and there were 5 cases which had slightly soreness after hard work and rainy days,1 case had tenderness in the contra-lateral leg 6 years after the operation,however,it has not deteriorate deeply. Conclusion As the problem of lumbar disk herniation associated with posterior bony edge separation,CT scan is most valuable,not to treat by traction and massage,bilateral laminectomy fenestration is one of the exact effective methods.