侧隐窝与腰骶神经根相对关系的临床研究

Clinical study of the relationship between the lateral recesses and the nerve roots

为揭示侧隐窝入口区之正常侧隐窝和狭窄侧隐窝与相应腰骶神经根的相对关系及其临床意义，作者对５０例正常者、４３例狭窄者和３２例狭窄症者腰骶椎ＣＴ扫描片编序拍摄输入计算机，由ＶＩ－ＤＡＳ图像分析系统统一按自行设计的测量法对入口区侧隐窝矢状径、上关节突间径和与侧隐窝相应的神经根距所设侧隐窝内口ａｂ线间径进行了测量。结果表明：正常情况下神经根均居侧隐窝内口ａｂ线侧隐窝一侧，但随着上关节突退变内聚程度逐渐加剧，使神经根靠近并跨越侧隐窝内口ａｂ线一侧，终致受狭窄侧隐窝的嵌夹。作者认为，侧隐窝入口区狭窄的真正临床意义在于直接危害神经根，但决定因素是上关节突增生内聚的程度，而侧隐窝矢径值量化的实用价值取决于上述变化情况。作者同时就导致侧隐窝狭窄并危害神经根的椎间盘膨出／突出、黄韧带肥厚／钙化、后方纤维环断裂／骨化等病理变化及相关问题作了分析。

To explicate the relationship and the clinical signification between the normal or narrow lateral recesses and the nerve roots,we measured the diameter of the entrans zone of the lateral recess,the interval between the upper articular processes and the interval between the nerve root and ab line on 50 normal cases,43 narrow cases and 32 stenosis cases with VIDS image analysis system.The results showed that the nerve root was in the center side of the ab line in the normal station,with the degrees of the degeneration and cohesion ncreasing,the nerve root was in the lateral recess side of the ab line,and was compressed by the lateral recess.The authors considered that the real clinical signification of the entrance zone of the lateral recess was danger to the nerve root,but the deciding factors were the degrees of the degeneration and cohesion of the upper articular processes.The pathological conditions that resulted in the stenosis of the lateral recess and dangered the nerve root such as disc,flavum ligament and posterior port of the fibra ring were discussed in the article.