腰椎间盘突出合并椎间孔狭窄致L5神经根双卡综合征一例报告

神经双卡综合征(double crush syndrome,DCS)指神经局部损伤后引起神经对压迫等刺激的敏感性增加,导致轻微的损伤性刺激即会造成神经的其余部位出现明显损伤症状的临床综合征[1]。多见于颈神经根卡压合并腕管、肘管综合征等[2]。既往报道腰椎DCS可发生于腰骶移形椎横突肥大增生并压迫L5神经同时合并椎管内压迫者[3],即far-out综合征[4-6]。在老年人群中,腰椎间孔狭窄合并椎管内压迫者并不少见,但中青年人因L5 DCS就诊却很少,若重视不足容易误诊误治。

L5 nerve double crush syndrome following disc herniation and foraminal stenosis:a case report

Objective To investigate the diagnosis and treatment of L5 nerve double crush syndrome following disc herniation and foraminal stenosis.Methods A retrospective analysis of 1 patient with severe L5 nerve injury was conducted.Results A 49-year-old female complained left lower limb pain,numbness and weakness for 25 days.L5 nerve double crush syndrome following disc herniation and foraminal stenosis was diagnosed after detailed history inquiry,medical examination,and auxiliary examination.L4-5 percutaneous transforaminal endoscopic discectomy,L5-S1 foraminoplasty and transforaminal ventral facetectomy were performed with satisfactory clinical outcomes.Conclusions L5 nerve double crush syndrome following disc herniation and foraminal stenosis is not common in the middle-aged.Misdiagnosis may occur after neglected foraminal stenosis.L4-5 percutaneous transforaminal endoscopic discectomy can not completely relieve symptoms.