CAJ | 학술논문

目的探讨多节段腰椎问盘突出症的临床诊断要点及有限手术治疗多节段腰椎间盘突出症的临床疗效.方法回顾分析我院2000年3月～2007年5月共用多节段开窗加神经根管减压的有限手术治疗多节段腰椎问盘突出症124例,全部病例术前均行X线片、CT或MRI检杏报告腰椎问盘多节段突出,临床体征与影像学报告相一致.术后平均5.6年经腰椎X线动力位片判定脊柱的稳定性,疗效按NAKAI标准进行术前、术后对比.结果 1124例均获随访8个月～7年,平均5.6年,疗效评定为:优68例、良37例、可17例、差2例,总优良率达84.7%.所有病例除有1例并发腰椎问盘突出症复发及2例并发椎间隙感染外,其余均无近期严熏并发症出现,也无腰椎失稳现象发生.结论多节段开窗的有限手术能在直视下切除椎间盘,彻底地松解神经根并维持脊柱的稳定性,最人程度地减少并发症的发生,是治疗多节段腰椎问盘突出症的有效和可靠方法 .
목적 탐토다절단요추문반돌출증적림상진단요점급유한수술치료다절단요추간반돌출증적림상료효.방법 회고분석아원2000년3월～2007년5월공용다절단개창가신경근관감압적유한수술치료다절단요추문반돌출증124례,전부병례술전균행X선편、CT혹MRI검행보고요추문반다절단돌출,림상체정여영상학보고상일치.술후평균5.6년경요추X선동력위편판정척주적은정성,료효안NAKAI표준진행술전、술후대비.결과 1124례균획수방8개월～7년,평균5.6년,료효평정위:우68례、량37례、가17례、차2례,총우량솔체84.7%.소유병례제유1례병발요추문반돌출증복발급2례병발추간극감염외,기여균무근기엄훈병발증출현,야무요추실은현상발생.결론 다절단개창적유한수술능재직시하절제추간반,철저지송해신경근병유지척주적은정성,최인정도지감소병발증적발생,시치료다절단요추문반돌출증적유효화가고방법 .
Objective To explore the clinica diagnosis of multisegmental lumbar disc herniationand the clinical effect of limited operative treatment for multiseg-mental lumbar disc herniation.Methods To retrospectively analyze clinical data of 124 cases with multisegmental,lumbar ,disc herniation treated by limited operation of multiole segmental fenestration plus foraminal stenosis decompression in our hospital during March 2000-May 2007.All the cases were diagnosed as multisegmental lumbar disc herniation by X-ray,CT or MRI before operation,whose clinical signs were accord-ant with radlologic findings .The stability of spinal was assessed by lumbar dynamics position X-ray film averaged 5.6 years after operation.The clinical assessment before and after the therapy was based on NAKAI standard. Results All 124 cases were fol- lowed up for 8 months-7 years,a mean time of 5.6 years.The results were excellent in 68 cases good in 37,fair in 17 and poor in 2,the overall excellent and good rate was 84.7%.There were no severe complications and lumbar unsteadihess except 1 case with recurrence and 2 cases with intervertebral space infection.Conclusions The limited operative treatment of multiple segmental fenestration could excise disc by eu- thyphora,relax the nerve root completely,maintain the stability of spinal,and maxi mize the decrease of complications.So it was one of effective and reliable treatments for multisegmental lumbar disc hermiation.