腰椎间盘突出症合并椎管内硬膜外血管畸形的解剖与临床特点

目的研究腰椎间盘突出症合并椎管内硬膜外血管畸形的解剖与临床特点。方法2001-2006年期间在我科手术治疗的7例腰椎间盘突出症合并椎管内硬膜外血管畸形,术前行MRI和选择性脊髓血管造影检查,均行椎间盘髓核摘除及畸形血管烧灼切除术。结果术中发现5例硬膜前方畸形血管,2例椎管内大量陈旧积血。术后症状消失或逐渐减轻,随访4年均无复发。根据Macnab疗效评定标准,优5例、良2例,无可及差。结论MRI、脊髓造影、手术探查是腰椎间盘突出症合并椎管内硬膜外血管畸形的主要诊断方法,充分认识其解剖与临床特点,有助于提高诊断准确率及手术疗效。

Anatomical and clinical features of lumbar disc herniation complicated with spinal epidural vascular malformations

Objective To study the anatomical and clinical features of lumbar disc herniation complicated with spinal epidural vascular malformations. Methods From January 2001 to December 2006, 7 cases with lumbar disc herniation (LDH) complicated with spinal epidural vascular malformations received surgical treatment in our department. The preoperative diagnosis was confirmed by MRI and selective spinal cord angiography. All herniated nucleus were removed regularly , meanwhile, all vascular malformations were excised by micro-cauterization. Results Spinal epidural vascular malformations were discovered in 5 cases and old hemorrhage inside vertebral canal were also found in 2 cases during operation. The symptoms disappeared or lessoned postoperatively. The preoperative symptoms did not recur during 4 years follow-up. According to Macnab evaluation standard, there were 5 excellent, 2 good and no fair or bad. Conclusion MRI, selective spinal cord angiography and surgical exploration are main diagnostic methods for LDH complicated with spinal epidural vascular malformations. To fully understand its anatomical and clinical features helps to increase diagnostic accuracy and the operative effect.