极外侧型腰椎间盘突出症的诊治分析(附11例报告)

目的 探讨极外侧型腰椎间盘突出症(FLLDH)的诊断及治疗.方法 本院2003年7月至2006年11月间诊治极外侧型腰椎间盘突出症患者11例,11例患者CT可清楚地显示位于椎间孔或椎间孔外缘突出的椎间盘,其中椎间孔型4例,椎间孔外型3例,椎间孔内外混合型4例,L2、33例,L3、43例,L4、53例,L5S12例,其中采用椎板间入路扩大开窗手术4例,椎板侧方手术3例,二者结合手术4例,疗效按中华骨科学会脊柱组腰背痛手术评定标准评估.结果 11例患者平均随访9个月,优7例,良3例,可1例,无差,优良率达90.9%.结论 CT是诊断FLLDH的主要依据,椎间孔型可采用椎板间扩大开窗术治疗,椎间孔外型可采用椎板侧方手术.

Diagnosis and treatment of far lateral lumbar disc herniation (with 11cases report)

Objective To investigate the diagnosis and treatment of far lateral lumbar disc herniations. Methods We treated 11 cases of far lateral lumbar disc herniations(FLLDH) from July 2003 to November 2006,4 cases were foraminal,and 3 cases were extraforaminal,and 4 cases were commix far lateral lumbar disc herniation. CT showed that the shadow density of the.CT values in the corresponding intra-foramen,ertra-foramen and all-foramen was as the same as that of the intervertebral disc. Of the 11cases,4 were operated on by the interlaminar approach,3 were operated on by the laterolaminar approach,4 were operated on by the combined interlaminar and laterolaminar approach. Results 11 cases were followed up for an average of 9 months. We obtained 7 cases excellent,3 cases good,1 fair and no poor. Excellent and good rates was 90.9%. Conclusions CT is a better way to diagnose FLLDH. The interlaminar approach is recommended to treat foraminal FLLDH,The laterolaminar approach is recommended to treat extraforaminal FLLDH.