摘要
目的：分析极外侧腰椎间盘突出的ＣＴ表现并分型，探讨各型特点、术式选择及临床疗效。方法：作者对极外侧型腰椎间盘突出症ＣＴ资料进行综合分析，认为可参照椎弓根位置，将其分为２型：Ⅰ型：椎间孔型，Ⅱ型：椎间孔外型。Ⅰ型中又将椎间盘突出近椎间孔内侧口或外侧口者分为Ⅰａ、Ⅰｂ２个亚型。Ⅰａ型手术取椎板间入路，Ⅰｂ、Ⅱ型取椎板侧方入路，部分合并后外侧椎间盘突出者同时行椎板开窗。Ⅰｂ、Ⅱ型如合并椎体滑脱或不宜从后路手术者取前侧腹膜外术式。结果：手术治疗１６例，经３个月～３年随访，结果参考Ｎａｋａｌ分级示优１０例，良５例，总优良率９３７％。结论：依据ＣＴ分型，合理选择术式，使手术具有创伤小，效果好，对腰椎稳定性影响小等优点。
Objective:To analyze CT classification,and the characteristics of each type of extreme lateral lumbar disc herniation (ELDH) and discuss choice of operative methods and clinical effect.Methods:According to synthetical analysis on CT data of ELDH,it could be classified in two types based on the situation of the pedicle of vertebral arch:Ⅰ,Foraminal type,Ⅱ,External foraminal type.And Type I could be classified into Ⅰ a and Ⅰ b,which was near the internal or external entrance of the intervertebral foramen.The operation of Ⅰ a took the approach through the vertebral lamina,Ⅰ b and Ⅱ took the approach lateral to the vertebral lamina.Some mixed posterolateral vertebral disc herniation took the approach of making a window in the vertebral lamina at the same time.Ⅰ b and Ⅱmixed vertebral body dislocation and those who are not suitable for the operation by the posterior way could adopt anteriolateral extraperitoneal approach.Results:Sixteen cases followed up from 3 months to 3 years.The result was 10 excellent,5 good,total fine rate according the classification of Nakal was 93 7%.Conclusion:Selecting an appropriate method of operation based on CT classification,one could have little traumatic,good effective operation with little influence on the stability of spine so it was worth to recommend for popularization.
出处
《中国矫形外科杂志》
CAS
CSCD
1999年第4期260-261,共2页
Orthopedic Journal of China
关键词
CT
外科手术
腰椎间盘突出症
治疗
Lumbar vertebrae Intervertebral disc displacements CT Surgical operation.
