摘要
目的:探讨向上游离的腰椎间盘突出症的诊断与治疗。方法:17例向上游离的腰椎间盘突出症患者,男9例,女8例;年龄27～54岁,平均41岁。全部患者均有明确的神经根受压的临床表现,腰椎MRI表现为病变椎间盘突出后向上游离,挤压马尾神经。全部进行了手术治疗,并随访观察治疗效果。结果:手术时间50～180 min,平均80 min;出血量20～350 ml,平均170 ml。2例术后出现脑脊液漏。使用29分法JOA评分,患者从术前的6.7分恢复到术后14 d的24.2分,及术后3个月的26.5分,疗效满意。结论:向上游离的腰椎间盘突出症临床上易误诊为腰椎管内肿瘤。确诊需要依据术者经验和强化腰椎MRI。此型腰椎间盘突出症均需手术治疗,减压切除椎间盘的同时要考虑腰椎稳定性的问题。
Objective： To evaluate diagnosis and treatment of upward lumbar disc herniation. Methods： 17 patients including 9 male and 8 female were treated in our department from June 2004 to May 2007. The age ranged from 27 to 54 years （mean, 41 years）. They had definite clinical manifestation of nerve roots compressed. Lumbar MR! revealed the diseased intervetabral disc herniated and upward sequestrated, compressing nerve roots. All of them were underwent operation and followed-up. Results： The average operation time was 80 min （range, 50-180 min）, the average blood loss was 170 ml （20~350 ml）. Two cerebrospinal fluid leak occurred after operation. According to JOA（29 scores） evaluation standard, the score of preoperation was 6.7, rising to 24.2 at 14^thday and 26.5 at 3^rd month postoperation. The clinical effect was satisfied. Conclusion： Upwaed lumbar disc herniation is often misdiagnosed as intraspinal tumor. Confirmed diagnosis depends on the operators＇ experience and intensive MRI, Operation is necessary for this type of lumbar disc herniation. We must think about the lumbar stability while decompression and discecetomy.
出处
《天津医科大学学报》
2007年第4期579-580,594,共3页
Journal of Tianjin Medical University
关键词
腰椎间盘突出
诊断
治疗
Lumbar disc herniation
Diagnosis
Treatment
