极外侧型腰椎椎间盘突出致病相关因素分析及防治

目的探讨作为特殊类型的极外侧型腰椎椎间盘突出症(far lateral lumbar disc herniation,FLLDH)的临床表现独特性及其病因、发病危险因素及致病机理,进一步总结提高对该疾病的认识。方法回顾分析本院近10年PLLDH病例资料58例,通过归纳分析该病的症状特点及原因,评价手术后患者恢复情况及手术效果,总结致病相关因素及防治策略。结果 FLLDH主要见于重体力劳动者,具有根性症状重、直腿抬高试验阳性率低、病史短等特点,多数患者非手术治疗无效需手术治疗。结论 FLLDH做为一种特殊类型椎间盘突出症,可以通过各种方法进行早期预防,MRI技术有助提高确诊率,经侧后路植骨融合患者手术后腰椎失稳、腰部疼痛的情况明显少于单纯髓核摘除减压,2种手术均是快速缓解下肢根性症状、提高生活质量的良好选择。

Analysis of correlation factor and prevention strategyand of far lateral lumbar disc herniation

Objective To discuss the clinical manifestations, risk factors and pathogenesis of extreme lateral lumbar intervertebral disc herniation, and to summarize and increase awareness of the disease. Method Clinical data of 58 cases in the latest 10 years was analyzed retrospectively. The symptoms and causes of the disease were summarized and analyzed, and the recovery of the patients and the effect of surgery were analyzed. Pathogenic factors and prevention strategies were comprehensive evaluated. Result The patients with extreme lateral lumbar disc herniation mainly existed in workers who engaged in heavy physical labor, with feature of heavy radicular symptoms, lower positive rate in straight leg raising test, and shorter history. Once the patients were diagnosed, surgical treatment were mostly needed after the ineffective conservative treatment. Conclusion Extreme lateral lumbar intervertebral disc herniation, as a special lumbar intervertebral disc herniation, can be prevented early through a variety of methods. Various of MRI techniques can help to improve the diagnosis rate. The patients through lateral road with bone fusion have a significantly lower rate of lumbar instability and back pain than the group with discectomy decompression only. Both operations are good choice to quickly relieve the radicular symptoms of the lower limb and improve the quality of life.