发育性腰椎椎管狭窄合并腰椎间盘突出症

目的：探讨发育性腰椎椎管狭窄合并腰椎间盘突出症的病理特点、诊断和治疗。方法：报告４２例发育性腰椎椎管狭窄合并腰椎间盘突出症，计男２９例，女１３例，年龄１９～４４岁，平均３１．７岁。均采用经椎板间开窗行椎间盘切除术治疗。结果：随访２～７年，平均４．４年。２８例术前症状完全消失，１３例根性疼痛或间歇性跛行症状消失但仍遗有腰痛，１例症状体征消失６年后又出现间歇性跛行。结论：腰椎椎管狭窄和腰椎间盘突出系两种独立的疾病，发育性椎管狭窄往往只是致病的条件而非决定因素，当合并椎间盘突出时经开窗行单纯椎间盘切除术即可取得满意疗效行椎板切除术并无必要

Lumbar Disc Herniation in the Patients with Developmental Spinal Stenosis

Objective:To invetigate the pathological characteristics,diagnosis and treatment of lumbar disc herniation in patients with developmental spinal stenosis.Methods:Forty two lumbar disc herniations with developmental spinal stenosis were retrospectively reviewed and analyzed.There were 29 males and 13 females,aged 19 to 44 years (mean, 31 7 years). Discectomy was performed after laminotomy on all patients.Results:The patients were followed up for 2 to 7 years (mean,4 4 years). The preoperative symptoms disappeared completely in 28 patients,some degree of backache remained in 13 patients although the nerve root pain had been relieved and after 6 year resolution of the preoperative pain the intermittent claudication reappeared in one patient. Conclusion:Lumbar spinal stenosis and lumbar disc herniation are totally different pathological processes.Developmental stenosis of the lumbar spine is a conditional but not absolute determinant of neural compression.When developmental spinal stenosis is combined with disc herniation,discectomy through laminotomy rather than laminectomy is usually sufficient for decompression.