腰椎间盘突出症的椎间盘切除前后神经根血流变化

目的：观察腰椎间盘突出症临床表现与神经根血流变化的关系。方法：应用激光多普勒血流测量仪测量24例病人椎问盘切除手术前后神经根血流的变化，分析其相关因素。结果：术后下肢痛早期缓解病人神经根血灌流量增加明显高于延期缓解病人，神经功能障碍早期恢复病人神经根血灌流量增加明显高于延期恢复病人，破裂型病人较未破裂型病人术后神经根血灌流量增加明显。结论：术后早期坐骨神经痛缓解和神经功能障碍恢复是间盘切除术后神经根血运恢复的结果，机械性压迫导致的神经根缺血是坐骨神经痛和神经功能障碍的根本原因。

Changes of nerve root blood flow during discectomy for lumbar disc herniation

Objective:To investigate the relation between nerve root blood flow changes during discectomy and clinical features associated with lumbar disc herniation.Method:Nerve root blood flow was intraoperatively measured before and after discectomy for lumbar disc herniation in 24 patients using laser Doppler flowmetry during discectomy.Possible correlations were investigated.Result:The increase in nerve root blood flow in patients whose neurologic deficits resolved or whose leg pain did relieve soon after the operation was greater than that in patients whose neurologic deficit did not recover or whose leg pain did not relieve soon after the operation.The increase in nerve root blood flow in patients whose herniated discs had ruptured the posterior longitudinal ligament (PLL) was found to be significantly greater than that in patients whose herniated discs had not ruptured the PLL.Conclusion:The results suggest that immediate relief from leg pain and resolution of neurologic deficits soon after surgery are the result of early recovery from nerve root ischemia after discectomy,and that ischemia caused by mechanical nerve root compression is mainly related to the mechanisms underlying sciatic pain and/or numbness production and neurologic deficits.