脊髓造影CT对腰椎间盘突出合并侧隐窝狭窄的诊断价值及对其处理

Computed Topographic Myelography Diagnosis Value and Treatment in Lumbar Disk Herniation with Lateral Recess Stenosis

腰椎间盘突出合并测隐窝狭窄手术治疗失败的主要原因是术前对侧隐窝狭窄不能准确定位，术中只满足椎间盘的摘除，而忽略侧隐窝减压。我们对这类32例患者，诊断采用脊髓造影CT（CTM），其与手术的符合率为100％，手术采用以半推板为主要入路腰椎间盘摘除和侧隐窝扩大术。平均随访27个月，优良率达96．9％，本文还详细介绍CTM检查的方法和征象，以及手术操作要点。

The major causes of failure in treating lumbar disk herniation with lateral recess stenosis were related to the facts that lateral recess could not be accurately located before operation and that the lumbar disk was extracted while lateral recess could not be radically decomprecced in operation. In 32 patients the computed topographic myelography (CTM) was used to diagnose these diseases. Their findings and surgical exploration were as high as 100%. and the extraction of lumbar disk and enlargement of lateral recess through the excision of hemilaminectomy was applied to treat them. 29 patients have been follwed up for 12 to 29 months and good and excellent rate was as high as 96. 6%. This paper introduces the method andsigns of CTM and the main opintion of operation in detail.