极外侧型腰椎间盘突出症的特征及分型——附36例报告

Analysis of the clinical feature and typing of 36 cases of extreme lateral lumbar disc herniation

目的:探讨极外侧型腰椎间盘突出症的特征及分型。方法:对36例极外侧型腰椎间盘突出症患者的临床症状、体征及影像学结果逐项进行分析。结果:发现极外侧型腰椎间盘突出症具有症状重、体征明显、多损伤同位神经根,一半以上损害两神经根以及保守治疗效果差等特征。根据影像学突出物的位置作者将其分为3型:即神经根管型、外口型和混合型。根据不同的类型,采取不同的手术方式,取得了良好的效果。结论:极外侧型腰椎间盘突出症症状重,保守治疗基本无效,应尽早进行手术治疗。

Objective:To investigate the feature and the typing of extreme lateral lumbar disc herniation(ELLDH().)Method:The clinical symptoms,physical signs and imageologic character of 36 cases of ELLDH were analyzed.Result:Clinical syndromes of ELLDH were often more severe than common lumbar disc herniation,accompanied by very obvious physical signs.Clinical syndromes reflected compression of the superiorly exiting nerve root,ie,an L_(4~5) extreme lateral disc produces a L_4 root syndrome.More than half of the cases showed that two or more nerve roots were compressed,and conservative treatment often provided poor result.We divided them into three types based on the location of the herniated discs,intraforaminal,extraforaminal and mixed type.According to the types of the patients,different surgical approaches were used in operation,and effective decompression was obtained.Conclusion:ELLDH patients suffered more severe clinical complaints,and reserve treatments are often ineffective.Surgical decompression is refered in relieving radicular pain.