腰骶神经根异常的分型及其手术治疗

Classification and surgical treatment of lumbosacralnerve root anomalies

１２例经手术证实的腰骶神经根异常病例中，两神经根根部相连分开后即进入同一椎间孔者２例。两神经根在平椎弓根上缘水平，分别从硬膜腹侧及外侧发出，一条横行进入椎间孔，另一条斜行向下者１例。两神经根根部紧密相邻，在平椎弓根上缘水平一条横行进入椎间孔，另一条斜行向下者４例。单一神经根异常增粗，相邻神经根细小者５例。作者从指导治疗的角度出发，将其分为三型：Ｉ型：椎管或根管内神经根体积增大（包括单一神经根直径增粗及两神经根共进同一椎间孔）者；ＩＩ型：两神经根发出或走向异常者；ＩＩＩ型：混合型即同时具有Ｉ、ＩＩ两型改变者。

AbstractIn this paper 12 cases of lumbosacral nerve-rootanomalies proved on operations were reported.Tworoots with a common conjoined origin entering thecommon intervertebral foramen separately were seen intwo cases;two roots arising respectively from the lat-eral and ventral sides of the dural sac at the level of up-per margin of the pedicle,in which one ran transverse-ly into the foramen and another obliouelv ran down-ward,in one case;two roots with closely adjacent ori-gins, in which one ran transversely into the formen atthe level of upper margin of the pedicle and anotherobliguely ran downward,in four cases;a single rootwith abnormally large whereas the adjacent root withabnormally small,in five cases. We proposed a classi-fication method for the sake of appropriate surgicalprogramm,which assorted the anomalies into threetypes :(Ⅰ)General volume of nerve roots in the spinalcanal or nerve- root canal abnormally jncreased,eitherthe diameter of a single root increases or two roots en-tered the common. foramen;(Ⅱ)The origin andcourse of two roots were anomalous;(Ⅲ)Comhna-tion of I and Ⅱ.