无椎间盘突出的腰骶神经根压迫症的临床分型与治疗

Clinical typing and treatment of sacral nerve root compression without lumbar disc protrusion

目的 探讨无椎间盘突出的腰骶神经根压迫症的临床分型与诊治方法。方法 对 4 3例无椎间盘突出的腰骶神经根压迫症行椎板切除或椎间孔减压术。结果 在 4 3例手术患者中 ,随访 33例 ,平均随访时间 3年 ,其中 32例下肢症状全部消失 ,1例残留下肢放射痛、足背伸力弱。结论 无椎间盘突出的腰骶神经根压迫症原因复杂 ,有 7种类型 ,分别为不合并椎间盘突出的神经根管狭窄症、神经根畸形、神经根节异位畸形、神经根鞘膜瘤、神经根囊肿、椎间静脉曲张畸形、椎间盘吸收综合征。其临床表现类似椎间盘突出症 ,易造成误诊及术中失误 。

Objective To investigate the clinical typing and treatment of sacral nerve root compression without lumbar disc protrusion Methods 43 cases of sacral nerve root compression without lumbar disc protrusion were treated with laminectomy or decompression of the intervertebral foramen.Results 33 cases had follow up of 3 years.Symptom in lower limbs of 32 cases disappeared after surgery.One case still had radiating pain of lower limbs and weakness in dorsiflexion of the foot.Conclusion The clinical typing and cause of sacral nerve root compression without lumbar disc protrusion are complicated and the condition can be divided into 7 types:nerve root canal stenosis,nerve root anomalies,ectopic deformity of the dorsal root ganglia,schwannoma,nerve root cyst,intervertebral varix anomalies,intevertebral and disc absorption syndrome.The symptoms of these conditions are similar to protrusion of interevertebral disc and are easily to be misdiagnosed as well as leading to mistakes in surgery.These cases should be treated according to their individual findings during surgery.