腰椎脊柱狭窄症由脊柱外周脂质瘤症加重:一个病例报告
Yide Fang1, Zhenghang Bian1, Zhengyi Tong1
1Department of Orthopedics, Longhua Hospital, Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Frontiers in surgery
|February 26, 2026
概括
选择性神经根阻塞 (SNRB) 引导分阶段的微创性减压有效治疗脊椎脊柱狭窄症 (LSS) 由脊柱外周脂肪瘤 (SEL) 复杂化. 这种方法精确地针对症状水平,从而显著减少疼痛和改善功能.
科学领域:
- 神经外科 神经外科
- 脊柱外科手术 脊柱外科手术
- 疼痛管理 疼痛管理
背景情况:
- 腰椎脊柱狭窄症 (LSS) 和脊柱外周脂质增生症 (SEL) 可能会带来复杂的诊断挑战.
- 吸入的葡萄皮质类药物已与SEL的发展有关.
- 在多层次的腰部病理学中,区分症状的主要来源对于有效的治疗至关重要.
研究的目的:
- 描述LSS和SEL患者的临床表现,诊断方法和康复情况.
- 评估选择性神经根阻塞 (SNRB) 在指导复杂的腰部病理的分阶段的微创性减压中的实用性.
- 为了评估SNRB引导的分阶段解压后的功能结果.
主要方法:
- 分析了一个65岁男性的神经性听和麻木的案例研究.
- 手术前的成像包括放射,CT和MRI.
- 使用SNRB定位症状水平,随后进行分阶段的关节镜辅助单门性减压.
主要成果:
- SNRB将L4/5确定为主要的症状水平,导致最初的减压,疼痛明显改善 (VAS 7至4) 和残疾 (ODI 52至38).
- 在L5/S1处进行持续麻木的第二阶段减压,进一步减少疼痛 (VAS至2) 并改善运动力.
- 在4个月的随访中,ODI改善到20,SF-36分数显著增加,行走耐受性明显改善,残留麻醉症最小.
结论:
- SEL可以加剧或揭露退行性LSS的症状,呈现出独特的恢复模式.
- SNRB是通过SEL复杂化的多层次腰部病理学进行分阶段的微创性去压的精确水平选择的宝贵工具.
- 由SNRB引导的分阶段解压提供了一种精确有效的策略,用于在复杂情况下实现有利的功能结果.
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