神经根鞘膜切开减压对腰椎间盘突出症术后神经功能恢复效果的探讨

Effects of Incision of Nerve Root Sheath in Patients with Lumbar Disc Protrusion

目的：观察神经根鞘膜切开减压对促进腰椎间盘突出症术后神经功能恢复的效果。方法：自１９９２年４月～１９９７年４月对２６例腰椎间盘突出症病人行间盘切除的同时，将增粗的神经根鞘膜切开减压，并与同期３０例作比较。２组病人术前除腰腿疼痛外，患肢麻木症状重或伴趾背伸肌力减弱，术中均有神经根明显增粗，苍白表现。切开组自神经根出口０５ｃｍ向远侧切开鞘膜，长度约１ｃｍ左右，见神经纤维明显膨出。结果：切开组术后患肢麻木及趾背伸肌力恢复快，２组在术后２周及半年存在显著差异（Ｐ＜００１）。结论：神经根鞘膜切开减压，能迅速促进腰椎间盘突出症病人术后神经功能的恢复。

Objective:To evaluate the effects of incision of nerve root sheath in patients with lumbar disc protrusion.Methods:26 cases with lumbar disc protrusion from April 1992 to April 1997 were selected.Lumbar discectomy and incision of the sheath of the thickened nerve root were performed,which include longitudinal incision about lcm away 05cm from the exit of nerve root,and the nerve tracts were clearly seen.Another 30 cases with the same lesions and same symptoms underwent discectomy merely served as control group.Results:The numbness of the affected limb and the muscle strength of the big toe were recovered more quickly in decompressed nerve root sheath group.There were significant difference between two groups in 2 weeks and half a year after operation(P<001).Conclusion:Incision of the sheath of nerve root could promote the recovering of the nervous function in patients with lumbar disc protrusion.