摘要
目的 分析腰椎椎体后缘骨块物的特点及手术方法。方法 195 5年 5月～ 2 0 0 2年 12月手术治疗腰腿痛患者 115例 ,将其中 4 2例腰椎CT片上表现为椎体后缘骨块物影的患者 ,结合临床特点 ,分析其病因 ,针对不同病因及CT特征进一步诊断 ,采用单或双侧扩大开窗 ,或半椎板充分显露 ,运用特殊器械、特殊方法治疗。结果 4 2例中 ,腰椎间盘突出钙化 19例 (4 5 .2 % ) ,椎间盘软骨板破裂 14例 (33.3% ) ,腰椎间盘突出伴椎体后缘骨赘 7例 (16 .7% ) ,椎间盘突出并后纵韧带骨化 1例 (2 .4 % )。随访 6个月～ 6年 ,平均 2年 3个月。 4 2例患者的下肢痛、间歇性跛行全部消失 ,恢复原有工作和正常生活 ,但有 2例足趾及小腿麻木未完全消失。根据改良的Macanab疗效评定标准 ,优 2 8例(6 6 .8% ) ,良 11例 (2 6 .2 % ) ,可 2例 (4 .8% ) ,差 1例 (2 .4 % ) ,优良率达 92 .8%。结论 腰椎椎体后缘骨块物的病因有 :突出椎间盘钙化 ,腰椎软骨板破裂 ,椎间盘突出并椎体后缘骨赘 ,椎间盘突出合并后纵韧带骨化。
Objective To study the characteristics of bone mass at posterior edge of the lumbar vertebral and resection method. Methods From May 1995 to December 2002, 115 cases with protrusion of the lumbar intervertbral disc were treated by surgeries. Among them, CT graphs of 42 cases showed the bone mass at posterior edge of the vertebrae .They were analyzed and resected by specific approaches. Results Among 42 cases, 19 cases (45.2%) were calcification of lumbar intervetebral disc protrusion, 14 (33.3%) were rupture of cartilaginous endplate,7(16.7%) were lumbar vertebral disc herniation with osteophyte at posterior edge of vertebrae and 1 (2.4%) was lumbar intervertebral disc herniation with OPLL. The mean follow-up periods was 27 months (range 6 months to 6 years).The lower limb pain and intermittent limping in 42 cases were disappeared completely and the patients resumed their normal activities. The numbness of the toes and external area of the tibial region did not disappear completely in 2 of 42 cases. The results showed that 92.8% of the cases were graded as excellent and good. Conclusion The pathogenic factors of the bone mass at posterior edge of the vetebral were as the follow: calcification of lumbar intervetebral disc protrusion, rupture of cartilaginous endplate, osteophyte at posterior edge of vertebrae with calcification of posterior longitudinal ligament.
出处
《脊柱外科杂志》
2004年第2期69-71,78,共4页
Journal of Spinal Surgery
