极外侧型腰椎间盘突出症的手术治疗

目的总结极外侧型腰椎间盘突出症的手术方法和疗效。方法采用经椎旁肌间隙入路或改良经椎板间隙法入路,有限开窗,腰椎间盘摘除。结果37例病人,随访36个月~6a,83.8%的病人疗效满意。结论极外侧型腰椎间盘突出症具有特殊的临床特征,薄层高分辨CT是诊断本症的最好方法。手术入路应依据突出间盘组织的占位、病理类型、是否合并椎管内病变及术者对各种手术入路的熟练程度而定。早期手术,术中准确定位,微创操作及术后引流可提高手术疗效。

Operation Treatment for Extreme outer Lumbar Disc Herniation

Objective To sum up the operation methods and therapeutic effect for extreme outer lumbar disc herniation. Methods To adopt the way of entering the path throught the vertebra nearby and muscle, or reforming the way of entering the path through the arcus vertebrace, then to open the window limitedly and to excise lumbar disc. Results 37 cases were followed up from 36 months to 6 years. The rate of satisfaction was 83.8%. Conclusion Extreme outer lumbar disc herniation has special clinical characteristic. High distinguishing thin layer CT is the best way to diagnose the disease at present. The operation entering the path sholud depend on the tissue occupying, pathology type, whether merging pathological changes within the vertebra tube and how familiar the doctor is with all kinds of the operation entering the path. Early operation, accurately fixing positon, operation with slight injury and drainage after operation can all improve curative effect.