245例腰椎间盘突出症的手术疗效分析

THE RESULTS OF LUMBAR DISCECTOMY IN 245 CASES

本文报告,45例腰椎间盘突出症手术后1～33年的随访结果。并从椎间盘的自然退化变性规律以及不同年龄突出组织内容物的不同,结合临床发病规律讨论了保守治疗与手术治疗的适应证。作者强调腰椎向盘突出症只是引起腰腿痛的常见病因之一,决不可简单认为腰腿痛就是腰椎间盘突出症;其次不能单凭临床神经体征来推测病变水平。CT检查,尤其是结合椎管造影同时进行,对诊断有很大帮助。手术时如椎管内未见病损,应作小关节部分切除,显露侧隐窝以防遗漏。

The results of 245 cases of lumbar discectomy are reported. Based on the natural deterioration of the disc and the different nature of the protrusion in different ages, the authors proposed the indications for conservative and operative treatment. Lumbar disc protrusion is actually one of the causes of sciattica but not the sole cause, and there is no absolute reliability in deducing the location of the lesion solely by clinical nerve root dysfunction. CT scan especially CTMM is a very useful diagnostic measure to make certain the diagnosis. A partial facetectomy is mandatory to prevent missing of lesion located in the lateral recess if there is no lesion found in the spinal canal.