高位腰椎间盘突出症的手术治疗

Surgical treatment for upper lumbar disc herniation

目的 :探讨高位腰椎间盘突出症的临床特点、诊断及治疗。方法 :根据椎间盘突出部位与程度 ,分别采用 3种手术方式治疗高位腰椎间盘突出症 3 6例 ,其中采用单开窗法 2 1例 ,双开窗法 9例 ,半椎板切除法 6例。结果 :3 6例患者获随访 ,平均随访时间 3 1个月 ,优良率 91 7%。结论 :高位腰椎间盘突出症的临床表现复杂 ,强调早期手术以及术中注意保持脊柱稳定性 。

Objective To explore the clinical characteristics, diagnosis and treatment method of upper lumbar disc herniation. Methods Based on the position and degree of the upper lumbar disc herniation, 36 cases were treated with 3 different surgical methods: unilateral fenestration in 21cases, bilateral fenestration in 9 cases and semi-laminectomy in 6 cases. Results Thirty-two cases were foll owed up and the mean period was 31 months. The excellent good rate reached 91.7%. Conclusion The clinical manifestations of upper lumbar disc herniation were sever and atypical. The most patients should be undergone decompression of lumbar canal and excision of herniated disc througeh one or more laminal fenestrations in order to protect the spinal stability. During the operation, exploring the spinal canal carefully and resecting the herniated nucleus pulposus completely are the key to increase the curative effect.