摘要
目的 了解腰椎间盘突出合并腰骶神经背根节 (DRG)嵌压的机制。方法 12例腰椎间盘突出患者术中发现 :髓核切除后神经根张力仍较大并固定 ,沿神经根探查发现腰骶神经DRG充血并肿大 ,直径 0 8～ 1 2cm ,平均 1 1cm。嵌压物为增生的上关节突和增生肥厚的关节囊韧带。 12例病人共探查 15个DRG ,其中位于椎间孔 6例 ,椎管和椎间孔交界 7例 ,椎间孔外2例同时合并腰神经在椎间孔外嵌压。结果 术后腰腿痛完全缓解 9例 ,遗留轻度臀部牵涉痛 2例 ,无改善 1例。随访 0 5～ 5年 ,平均 1 8年。优 :9例 ,良 2例 ,无变化 1例。结论 腰椎间盘及椎间关节退行性变引起上关节突增生、关节囊韧带增生及肥厚 ,导致椎间孔狭窄 。
Objective To understand the mechanics of lumbar disc herniation(LDH) with entrapment of lumbo-sacral dorsal root ganglta(DRG).Twelve patients with LDH were operated for discectomy.On operation .the nerve roots had more tension and fixation,even after the discs were removed.The DRGs were found congestion and swelling,and were entrapped by the hyperplasia and hypertrophy of supprior articular process and capsular ligament,when explored along the course of the nerve roots.Its diameter were 0 8～1 2cm,average 1 1cm in twelve patients with 15 DRGs.The DRGs were located in intraforaminal in 6 cases ,connection of spinal cannal and intraforaminal in 7 cases,extraforaminal in 2 cases with the lumbar nerve entrapped out of intervertebral foramen.Results The lumbago and sciatica were relived completed in 9 patients,improved in 2 patients and not changed in one patient.Followed-up 0 5～5 years,average 1 8 years,there were excellent 9 cases,good 2 cases,no change 1 case.Conclusions Degenerative changes of lumbar discs and intervertebral articular lead to the hyperplasia and hypertrophy in supprrior artcular process and capsular ligament,and intervertebral foramen stenosis.The DRG lay within relatively.It is an important factor for the lumbago and sciatica as well as for those who have not improved or recurred after disectomy.
出处
《骨与关节损伤杂志》
2000年第5期349-351,共3页
The Journal of Bone and Joint Injury
