高位腰椎间盘突出症

Upper lumbar disc herniation

目的 探讨高位腰椎间盘突出症的临床特点、诊断和治疗。方法 根据突出部位与程度 ,分别采用五种不同的手术方法治疗高位腰椎间盘突出症 68例 ,其中侧方入路 1例 ,单开窗法 2 5例 ,双开窗法 13例 ,半椎板切除 18例 ,全椎板切除 11例。结果 42例患者获随访 ,平均随访时间 2 5个月 ,优良率 90 5 %。结论 高位腰椎间盘突出症的临床表现复杂 ,多伴有低位突出 ,应充分重视临床查体。手术中仔细探察椎管、重视狭窄侧隐窝的减压、注意潜行椎间盘突和脱出髓核是提高疗效 。

Objective To explore the clinical characteristics,diagnosis and treatment method of upper lumbar disc herniation Methods Based on the position and degree of the upper lumbar disc herniation,68 cases were treated with 5 different surgical methods:side approach in 1 cases,unilateral fenestration in 25 cases,bi lateral fenestration in 13 cases,semi laminectomy in 18 cases and total laminectomy in 11 cases.Results 42 cases were followed up and the mean period was 25 months.The excellent good rate reached 90 5%.Conclusion Upper lumbar disc herniation often combined with low disc herniation and has complicated clinical situation,so we should pay more attention to the physical examination.During the operation,exploring the spinal canal carefully and resecting the herniated nucleus pulposus completely are the key to increase the curative effect.