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手术治疗腰椎滑脱伴发椎管内囊肿（最新稿）
Surgical operation of lumbar spondylolisthesis combined with Synovial cyst

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DOI:
作者:
孔维清 徐建广 眭述平 张长青 曾炳芳
KONG Weiqing, XU Jianguang, SUI Shuping, ZHANG Cha
作者单位:
上海交通大学附属第六人民医院骨科
Department of Orthopedics,the Sixth People’s Hospital of Shanghai, Shanghai Jiaotong University, Shanghai 200233, China
关键词:
腰椎滑脱 椎管内囊肿 腰椎不稳
lumbar spondylolisthesis, Synovial cyst, instability
摘要:
[摘要] 目的 探讨手术治疗腰椎滑脱伴发椎管内囊肿的临床疗效。方法 对临床腰椎滑脱伴同节段椎管内硬膜外占位患者实施后路减压，肿块切除，滑脱节段融合内固定术。共25例患者，年龄41-68岁；男性15例，女性10例；其中L4-5,14例；L5S1,11例；术前患者均伴不同程度腰痛及下肢放射症状。滑脱程度：I度10例；II度9例；III度6例；术前常规行MR检查，术后对肿块行病理检测。随访患者术后融合情况及JOA评分。结果 术中完整切除肿块，术后病理结果均为椎管内囊肿。所有患者经6-12月随访均获得骨性融合，JOA评分较术前显著提高（平均提高7.5分）。结论 腰椎滑脱常常伴发椎管内囊肿，对肿块彻底切除的同时行滑脱节段融合内固定术有利于缓解患者的临床症状，防止囊肿的复发。对腰椎滑脱患者术前须常规行MR检查以免遗漏椎管内囊肿的诊断。
Abstract: Objective deplore the surgical effect of lumbar spondylolisthesis combined with Synovial cyst. Methods to those patients of lumbar spondylolisthesis combined with Synovial cyst, we conduct posterior decompression inter-body fusion and cyst resection. Altogether 25 cases, from 41 to 68; 15 are male and 10 are female. 14 cases are L4-5, 11 are L5-S1. all cases have symptoms of back pain and lower limb radiation. According to Meyerding classification 10 cases belong to I°;9 II°; and 6 III°.we make MR for all cases and do pathology routinely . patients were followed for bone fusion and JOA score. Results the results of the tumor were Synovial cyst for all patients. Everyone got bone fusion after 6-12 months’ follow-up. JOA score was significantly raised (7.5 in average). Conclusion lumbar spondylolisthesis is usually combined with Synovial cyst. conducting posterior decompression inter-body fusion and cyst resection at same time will alleviate the symptoms and prevent reoccurrence. Routine MR for patients of lumbar spondylolisthesis was necessary to avoid missing diagnosis

 

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