11例非典型休门氏病致腰椎间盘突出症的手术治疗

目的:运探讨非典型Scheuermann病致腰椎间盘突出症的临床特点及手术治疗方法。方法:2002年9月～2010年12月我院368例腰椎间盘突出症中合并有非典型Scheuermann病11例。男7例,女4例;年龄23～39岁,平均33.6岁。(L2/3)2个间隙,(L4/5)8个间隙,(L5S1)4个间隙。其中7名患者单纯采用后路椎板开窗髓核摘除术,4例患者采用腰椎后路椎管减压间盘切除、CAGE植入植骨融合+椎弓根钉内固定术。对手术疗效进行回顾性分析。结果:平均随访31个月,Oswestry评分从术前62.35±8.43分改善至21.46±7.98分。并获得较好的植骨融合,相邻节段无明显退变。出现并发症2例次,经对症处理后好转。结论:临床通过后路减压间盘切除,椎间植骨内固定术治疗非典型Scheuermann病致腰椎间盘突出症可获得良好临床疗效。

Surgical Treatment of the Lumbar Disc Herniations Companied with Atypical Scheuermann'sDisease in 11 cases

Objective:To explore the clinical features and the treatment of the lumbar disc herniations companied with Atypical Scheuermann’s Disease and to improve the level of recognition of it.Methods:From September 2002 to December 2010,we found 11 cases of the lumbar disc herniations companied with Atypical Scheuerman’s Disease in 368 cases,which need operation.There were 7 males,and 4 females aging from 23～39 years(mean,33.6 years).Two intervertebral spaces Were L2-L3 hernination,8 intervertebral spaces were L4-5 hernination,and 4 intervertebral spaces were L5S1 hernination of the space.7 cases were treated with resection of nucleus pulposus of lumbar disc only.Other 4 eases were treated with TLIF technique.A retrospective analysis on surgical therapeutic efect was made.Results:Two patients developed complications after operation and recovered by symptomatic treatment.Oswestry score improved from(62.35±8.43)to(21.46±7.98)in an average 31-months follow-up.X-ray showed that all cases had bone graft fusionand no adjacent segment degeneration occurred.Conclusion:Atypical Scheuerman’s Disease is one of the reason leads to lumbar disc herniations.The clinical features were common.Through operation,the clinical outcome was satisfactory.