极外侧腰椎间盘突出症的分型治疗

目的评价2种不同的手术方式治疗不同部位的极外侧腰椎间盘突出症的效果。方法极外侧腰椎间盘突出症11例,按突出部位分为椎间孔内型和椎间孔外型椎间盘突出,椎间孔内型椎间盘突出采用后路关节突切除,切除椎间盘、椎间植骨融合内固定术;椎间孔外型椎间盘突出采用经横突间入路单纯椎间盘切除术。结果横突间入路进行椎间盘切除平均手术时间50min,平均出血量180ml;后路椎间植骨融合内固定手术平均出血量330ml,平均手术时间120min。所有患者术后下肢疼痛症状均明显减轻或消失,神经根牵拉试验正常。经过平均术后12个月的随访,除2例术前部分肌力恢复不良外,其余患者恢复正常生活和工作。结论极外侧腰椎间盘突出症根据不同的突出部位分为2种类型,适宜采取不同的手术方式。

Surgical Treatment for Far- lateral Lumbar Disc Herniation by Different Types

Objective To investigate two surgical treatment methods for two different types of far-lateral lumbar disc herniation.Methods Eleven patients with far lateral disc herniation were divided into two types by the place of herniated disc,that is foraminal disc herniation(FDH) and extraforaminal disc herniation(EFDH).The patients with FDH were treated with posterior lumbar interbody fusion(PLIF) while the patients with EFDH were treated with intertransverse approach discectomy(IAD).Results The lower limbs pain of 11 patients were relieved after operation,by average 12 months of follow-up.All patients returned to normal daily life and work.However,the average operation time of IAD and PLIF was 50 min and 120 min respectively,and the blood loss was 180 ml and 330 ml separately.Conclusion It is necessary to divide the far-lateral lumbar disc herniation into different types.The patients with far-lateral lumbar disc herniation should be treated with different operations according to its types.