极外侧型腰椎间盘突出症的诊断和手术治疗

Diagnosis and operation treatment for extreme lateral lumbar disc herniation

目的探讨总结极外侧型腰椎间盘突出症的诊断和手术方法。方法回顾性分析21例患者,根据临床表现和影像学检查,确诊为极外侧型腰椎间盘突出症。其中腰椎间盘突出位于椎间孔内9例,椎间孔外5例,椎间孔内外并存7例。依照类型采取不同手术入路进行治疗,分别为椎管内入路3例,椎旁肌间隙入路13例,椎旁椎板侧方入路2例和椎管内外联合入路3例。结果随访时间30～50个月,平均41个月。19例患者完全恢复正常工作或生活,其余2例日常生活无明显影响。完全恢复正常工作或生活,其余2例日常生活无明显影响。患者满意率为95.2%。结论腰椎间盘突出症具有特殊的临床特点,将临床表现与影像学检查相结合才能正确诊断。根据椎间盘突出的部位、范围及是否合并椎管内病变等因素进行综合分析,选择合理安全的手术入路,才能获得满意的治疗效果。

Objective To express the methods of diagnosis and operation treatment for extreme lateral lumbar disc herniation. Methods 21 patients for extreme lateral lumbar disc herniation were diagnosed through clinical manifestation and image examination. 9 cases belong to inside of the intervertebral foramen, 5 case belong to outside intervertebral foramen and 7cases belong to con-type. Vary approaches were adopted for treatment according to the pathological type. Results The average follow up time was 41 months. 19 cases were completely recovery work or living,2 cases effected by the disease lightly. The rate of patient satisfaction was 95.2%. Conclusion Extreme lateral lumbar disc herniation has special clinical characteristic, definiting the diagnosis depended on clinical manifestation and image examination. The reasonable and safe operatin were choosed according to the hernia site and extent of lumbar disc and if it combine with intraspinal disease in order to gain satisfied curative effect.