腰椎椎体后缘离断合并椎间盘突出症的手术治疗

目的分析腰椎椎体后缘离断合并椎间盘突出症的发病机理,探讨手术治疗方法。方法 2006年10月—2009年3月期间共手术治疗10例腰椎椎体后缘离断合并腰椎间盘突出症病人,男8例,女2例,年龄18~40岁,平均27岁。根据症状及CT检查显示骨块突出部位采取不同手术方式。4例单侧开窗,2例单侧半椎板切除,2例双侧开窗。2例采用一侧半椎板切除,另一侧开窗,6例切除了骨块,4例骨块未予处理。10例均手术切除突出的椎间盘组织。结果术后随访6~36个月,平均18个月。8例腰痛及下肢症状基本消失;2例偶有腰痛发作。但较术前减轻,其下肢症状消失;1例足下垂病人术后1月症状明显恢复,足背伸肌恢复到4级;2例马鞍区麻木患者感觉基本恢复正常。结论本病发病机理主要还是由于青少年时期椎体后缘环状骨骺变异或损伤逐步引起椎间盘突出的继发改变,最终造成神经根和硬膜囊的压迫。椎体后缘骨块仅部分参与神经根压迫,椎管内神经根及硬膜囊的彻底减压才能达到满意效果。

Surgical treatment of posterior bony separation and intervertebral disk herniation of lumbar vertebrae

Objective To investigate the possible reason and operative methods of posterior bony separation and lumbar intervertebral disk herniation.Methods A retrospective study was carried out on the clinical features,imaging studies and the operative methods of 10 patients with posterior bony separation and lumbar intervertebral disk herniation.10 patients with posterior bony separation and lumbar intervertebral disk herniation,8 males and 2 females,aged from 18~40 years,mean 27 years old,were operated from October...