侧隐窝扩大在腰椎间盘摘除术中的重要性分析
作者：李勇 张连仁
单位：广州中医药大学附属珠海市中医院，广州 珠海 519015
关键词：侧隐窝狭窄；椎间盘移位；外科手术
中国骨伤000905摘 要：目的分析腰椎间盘突出合并侧隐窝狭窄的机理，侧隐窝松解对手术疗效的影响，探讨临床操作技巧，增进对侧隐窝狭窄的认识，提高手术疗效的稳定性和避免手术并发症。方法180例腰椎间盘摘除手术患者，常规采用椎板间开窗术式，术中注意对侧隐窝的探查和对神经根的彻底松解，灵活掌握术式，兼顾脊柱稳定性。结果147例获得随访，随访时间6个月至3年，优良133例，好转11例，无效3例，优良率达90.47%。结论腰椎间盘突出常合并侧隐窝狭窄，手术统计出现率为51.11%，术中注意侧隐窝的探查和松解，同时兼顾脊柱稳定性，是取得稳定疗效的关键。 Importance of lateral recess enlargement during the procedure of lumbar disk extraction
, 百拇医药
LI Yang ,ZHANG Lian-ren
(The Affiliated Zhuhai Hospital of TCM, Guangzhou University of TCM Guangdong Zhuhai, 519015)
Abstract：Objective To analyse the mechanism of lumbar disk herniation (LDH) with lateral recess stenosis, evaluate the effect of lateral recess enlargement on the surgical results, explore the operative technique, increase understanding of lateral recess stenosis and to improve lumber spinal stability of surgery and avoid complication. Methods 180 cases of LDH with lateral recess stenosis were treated with intervertebral fenestration. The lateral recess was explored and adequate decompressing of the nerve roots was carried out. Attention was paid to spinal stability during the operation. Results Of the 147 cases with a period of followup from 6 months to 3 years,excellent results were obtained in 133,good in 11 and no effect in 3. The excellent and good rate is 90.47%. Conclusion Surgical statistics shows 51.11% patients with LDH had lateral recess stenosis. During the operation for LDH, attention should be paid to the combined condition. Adequate exploration and release of lateral recess giving full attention to spinal stability is the key to obtain excellent results.
, http://www.100md.com
Keywords：Lateral recess stenosis Intervertebral disk displacement Surgery, operative
参考文献：
[1]李可心，马达.腰椎间盘突出症国外研究概况.中国骨伤，1997，10(3)：61-62.
[2]于天泉，刘昱，张进学，等.侧隐窝狭窄的边界值.骨与关节损伤杂志，1993，8(1)：7.
[3]Burton CV, Kirkaldy-Willis WH.Causes of failure of surgery on the lumbar spine.Clin Orthop，1981，157: 191.
[4]魏启赞，罗维富，龚晓玲.腰椎间盘摘除和侧隐窝扩大术(附86例报告).中华骨科杂志，1994，14(4)：203-204.
, http://www.100md.com
[5]赵敦炎，王世得.腰椎间盘突出合并侧隐窝狭窄的诊断和治疗.中华骨科杂志，1992，12(11): 44.
[6]陈晓华.腰椎间盘突出症合并侧隐窝狭窄症82例报告.颈腰痛杂志，1996，17(2)：112-113.
[7]胡有谷.腰椎间盘突出症.第2版，北京：人民卫生出版社，1995.282-283.
[8]饶书城.脊柱外科手术学.第2版.北京：人民卫生出版社，1999.24-25，578.
[9]李子荣，王福权.腰椎管侧隐窝狭窄症.国外医学·外科分册，1985，(3)：131.
[10]赵定麟.脊柱外科学.上海：上海科学技术文献出版社，1996.493.
[11]蒋位庄，周卫，李星，等.腰后关节紊乱症的病机和手法治疗的生物力学研究.中国骨伤，1994，7(3)：5.
, 百拇医药
[12]张世民，蒋位庄，张丰田，等.腰椎间盘神经支配的临床解剖学研究.中国骨伤，1996，9(5)：60-62.
[13]陆裕朴，王全平，侯树勋.腰椎管狭窄合并或不合并椎间盘突出症的手术治疗.中华骨科杂志，1988，8(3)：162-165.
[14]白波，余楠生，叶劲，等.腰椎间盘突出合并侧隐窝狭窄的CTM诊断和治疗.中华骨科杂志，1995，15(10)：658-660.
[15]李子荣.下腰部手术失败原因的探讨.中华骨科杂志，1988，8(6)：462，[16]杨克勤.脊柱疾患的临床与研究.北京：北京出版社，1993.620.
[17]蒋位庄，张世民，腰椎复合关节的生理功能及临床意义.中国骨伤，1995，8(6)：12-13.
[18]范明，朱立国，闫立.腰椎失稳的诊断.中国骨伤，1995，8(4)：31-32.
收稿日期：2000-03-07, 百拇医药
单位：广州中医药大学附属珠海市中医院，广州 珠海 519015
关键词：侧隐窝狭窄；椎间盘移位；外科手术
中国骨伤000905摘 要：目的分析腰椎间盘突出合并侧隐窝狭窄的机理，侧隐窝松解对手术疗效的影响，探讨临床操作技巧，增进对侧隐窝狭窄的认识，提高手术疗效的稳定性和避免手术并发症。方法180例腰椎间盘摘除手术患者，常规采用椎板间开窗术式，术中注意对侧隐窝的探查和对神经根的彻底松解，灵活掌握术式，兼顾脊柱稳定性。结果147例获得随访，随访时间6个月至3年，优良133例，好转11例，无效3例，优良率达90.47%。结论腰椎间盘突出常合并侧隐窝狭窄，手术统计出现率为51.11%，术中注意侧隐窝的探查和松解，同时兼顾脊柱稳定性，是取得稳定疗效的关键。 Importance of lateral recess enlargement during the procedure of lumbar disk extraction
, 百拇医药
LI Yang ,ZHANG Lian-ren
(The Affiliated Zhuhai Hospital of TCM, Guangzhou University of TCM Guangdong Zhuhai, 519015)
Abstract：Objective To analyse the mechanism of lumbar disk herniation (LDH) with lateral recess stenosis, evaluate the effect of lateral recess enlargement on the surgical results, explore the operative technique, increase understanding of lateral recess stenosis and to improve lumber spinal stability of surgery and avoid complication. Methods 180 cases of LDH with lateral recess stenosis were treated with intervertebral fenestration. The lateral recess was explored and adequate decompressing of the nerve roots was carried out. Attention was paid to spinal stability during the operation. Results Of the 147 cases with a period of followup from 6 months to 3 years,excellent results were obtained in 133,good in 11 and no effect in 3. The excellent and good rate is 90.47%. Conclusion Surgical statistics shows 51.11% patients with LDH had lateral recess stenosis. During the operation for LDH, attention should be paid to the combined condition. Adequate exploration and release of lateral recess giving full attention to spinal stability is the key to obtain excellent results.
, http://www.100md.com
Keywords：Lateral recess stenosis Intervertebral disk displacement Surgery, operative
参考文献：
[1]李可心，马达.腰椎间盘突出症国外研究概况.中国骨伤，1997，10(3)：61-62.
[2]于天泉，刘昱，张进学，等.侧隐窝狭窄的边界值.骨与关节损伤杂志，1993，8(1)：7.
[3]Burton CV, Kirkaldy-Willis WH.Causes of failure of surgery on the lumbar spine.Clin Orthop，1981，157: 191.
[4]魏启赞，罗维富，龚晓玲.腰椎间盘摘除和侧隐窝扩大术(附86例报告).中华骨科杂志，1994，14(4)：203-204.
, http://www.100md.com
[5]赵敦炎，王世得.腰椎间盘突出合并侧隐窝狭窄的诊断和治疗.中华骨科杂志，1992，12(11): 44.
[6]陈晓华.腰椎间盘突出症合并侧隐窝狭窄症82例报告.颈腰痛杂志，1996，17(2)：112-113.
[7]胡有谷.腰椎间盘突出症.第2版，北京：人民卫生出版社，1995.282-283.
[8]饶书城.脊柱外科手术学.第2版.北京：人民卫生出版社，1999.24-25，578.
[9]李子荣，王福权.腰椎管侧隐窝狭窄症.国外医学·外科分册，1985，(3)：131.
[10]赵定麟.脊柱外科学.上海：上海科学技术文献出版社，1996.493.
[11]蒋位庄，周卫，李星，等.腰后关节紊乱症的病机和手法治疗的生物力学研究.中国骨伤，1994，7(3)：5.
, 百拇医药
[12]张世民，蒋位庄，张丰田，等.腰椎间盘神经支配的临床解剖学研究.中国骨伤，1996，9(5)：60-62.
[13]陆裕朴，王全平，侯树勋.腰椎管狭窄合并或不合并椎间盘突出症的手术治疗.中华骨科杂志，1988，8(3)：162-165.
[14]白波，余楠生，叶劲，等.腰椎间盘突出合并侧隐窝狭窄的CTM诊断和治疗.中华骨科杂志，1995，15(10)：658-660.
[15]李子荣.下腰部手术失败原因的探讨.中华骨科杂志，1988，8(6)：462，[16]杨克勤.脊柱疾患的临床与研究.北京：北京出版社，1993.620.
[17]蒋位庄，张世民，腰椎复合关节的生理功能及临床意义.中国骨伤，1995，8(6)：12-13.
[18]范明，朱立国，闫立.腰椎失稳的诊断.中国骨伤，1995，8(4)：31-32.
收稿日期：2000-03-07, 百拇医药