22例极外侧型腰椎间盘突出症的诊断及手术治疗

Experience of diagnosis and operative treatment in 22 cases of FLLDH

目的探讨极外侧型腰椎间盘突出症的诊断及较为合适的手术方式。方法回顾性总结22例极外侧型腰椎间盘突出症临床资料,手术采用经峡部外缘入路椎间盘髓核摘除术13例,关节突内侧部分切除减压加经峡部外缘入路椎间盘髓核摘除术9例。结果所有病例随访6个月～5年,平均3年,无1例复发及腰椎不稳,优良率为86．36％。结论根据典型根性疼痛症状、体征和恰当的CT检查可诊断本病,同时结合极外侧型腰椎间盘突出症较典型神经根性症状和体征以及高质量的椎间孔区CT检查结果选择合适的手术治疗方式,是术后取得良好效果的关键。

Objective To study the far lateral lumbar disc herniation（FLLDH） and to find an appropriate operation way. Methods Thirteen of 22 FLLDH cases were operated from the outer edge of par interarticularis to extirpate nucleus pulposus and 9 were operated from the inner edge and reducing pressure as well as extirpating intervertebral disk from the outer edge of par interartieularis. Results All eases were observed for 6 months to 5 years（average 3 years） and none of them recurred. The excellent and good cases accounted for 86.36 %. Conclusion This disease can be diagnosed by typical root pain, physical sign and proper CT examination. Combining typical neural root symptom of FLLDH with physical sign as well as high quality CT examination of intervertebral holes,choosing a appropriate operative way is a key to get satisfactory result.