胸椎间盘突出症的诊断和手术治疗(附15例报告)

Diagnosis and Operative Methods of Thoracic Disc Herniation

目的 :探讨胸椎间盘突出症的临床表现、诊断及手术效果。方法 :回顾 15例胸椎间盘突出症的临床特点及影像学改变、手术治疗方法。全椎板切除减压椎间盘摘除 3例 ,侧前方或侧后方入路摘除椎间盘 8例 ,全椎板切除侧后方入路摘除椎间盘 4例 ,随访 1～ 10年 ,手术优良率达 80 %。结论 :理学、CT或MRI检查对确诊与定位有重要价值。根据椎间盘突出的大小、位置等情况可选择其入路。侧前方或侧后方入路及全椎板切除侧后方入路摘除椎间盘是治疗胸椎间盘突出症的有效、较安全术式。

Objective: To study the clinical manifestation,diagnosis and surgical results of thoracic disc herniation.Methods:The clinical appearances from 15 cases with thoracic herniation were analyzed ,to study their clinical feature and imaging data ,instruct operative methods. Results: The thoracic disc protrusion of 3 cases were resected with laminectomy through posterolateral approach .Eight cases were removed transversoarthropediculectomy through posterolateral or costotransversectomy through anterolateral approach and 4 cases were resected with laminactomy and transversoarthropediculectomy. The following up period were from 1 to 10 years, excellent and good results were obtained in 80% of the patients. Conclusion: Systematic examination, CT or MRI is valuable for the diagnosis of thoracic disc protrusion. Operative treatment is an effective safe way with posterolateral or anterolateral approach and both laminectomy and transversoarthropediculectomy for thoracic disc protrusion.