椎管内外联合入路治疗双神经根受压型腰椎间盘突出

Combined Intra-extracanal Approach to Lumbar Disc Herniations with Bi-radicular Compression

目的总结椎管内外联合入路治疗双神经根受压型腰椎间盘突出的临床应用结果。方法自2008年1月至2013年1月,应用椎管内外联合入路治疗双神经根受压型腰椎间盘突出6例,其中男5例,女1例。患者年龄28~56岁,平均36.8岁。椎间盘突出症状持续时间：最短6个月,最长3年,平均21个月。应用标准的椎间隙显露联合横突间显露,经两个手术窗去除了椎间盘突出,解除了双神经根的压迫。结果术后随访20~66个月,平均44个月,术后恢复率根据Macnab腰腿痛手术治疗评定标准进行疗效评定,优4例,良2例,没有发生与该项技术操作相关的并发症,取得了满意的治疗效果。结论椎管内外联合入路技术很适宜用单入路方法治疗有困难的双神经根受压型腰椎间盘突出。

Objective To summarize clinical application results of Combined intra-extracanal approach to lumbar disc herniations with bi-radicular compression. Methods From January 2010 to January 2013,6 patients（ 5 men,1 women） with lumbar disc herniations with bi-radicular compression were treated by combined intra-extracanal approach. They ranged in age from 18 to 46 years（ mean,26. 8y）. The duration of disc herniations symptoms ranged from 6 months to 3 years（ mean,21months）. A standard interlaminar exposure was combined with an extraforaminal intertransverse exposure. The herniated discs were removed using two operative windows and decompressing both nerve roots. Results Follow-up period ranged form 20 to66 months（ mean,44 months） postoperatively. The recovery results was calculated with Macnab scores. There were 4 excellent results,2 good results. No apparent complications related to the technique. Satisfactory clinical results were obtained in this series. Conclusion Combined intra-extracanal approach technique may be particularly useful in the treatment of lumbar disc herniations with bi-radicular compression where one approach are not possible.