椎间盘手术导致足下垂的临床研究

Clinical study on postoperative foot drop caused by operation method of protrusion of the lumbar intervertebral disc

目的:探讨巨大或游离型腰椎间盘突出症的手术方法的,改进避免术后足下垂的发生。方法:对65例术前未出现足下垂的椎间盘突出症患者,40例术中缓慢牵拉神经根接近中线,完全暴露突出髓核的操作方法,术后3例出现足下垂;25例通过手术方法的改进,术后未出现1例足下垂。结果:1次牵拉神经根接近中线完全暴露突出椎间盘组织,是引起手术导致足下垂的危险因素。结论:术中采用边松解粘连边适当牵拉神经根边逐渐取出突出椎间盘组织,无张力下牵拉神经根,是预防手术导致足下垂的重要方法,切记避免神经根在张力极限的情况下过度牵拉。

Objective：To explore the improvement of operation method of large or free protrusion of the lumbar intervertebral disc to avoid postoperative foot drop.Methods：65 cases not preoperative foot drop in patients with disc herniation,40 cases of slow dragging nerve root was close to the midline,operation method completely exposed to nucleus pulposus,after 3 patients had foot drop;improved in 25 cases by operation method,postoperative does not appear in 1 patients with foot drop.Results：As a result of dragging nerve root was close to the midline completely exposed the herniated disc tissue,was caused by the operation risk of foot drop factor.Conclusion：Using the lysis of adhesions edges due to pulling the nerve root edge gradually remove the herniated disc tissue without tension,pulling the nerve root,might be an important method to prevent foot drop operation,remember the nerve root in the tension limit in case of excessive traction to avoid.