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[关节突囊肿切除术后的结果 - 节段性不稳定起何种作用?]

[Results after resection of juxta-facet-cysts - Which role does a segmental instability play?].

作者信息

Franke J, Mahlfeld K, Grasshoff H

机构信息

Orthopädische Universitätsklinik, Otto-von-Guericke-Universität Magdeburg, Germany.

出版信息

Zentralbl Chir. 2002 Jun;127(6):497-502. doi: 10.1055/s-2002-32615.

Abstract

This study demonstrates the results after operative treatment of patients suffering from a lumbar Juxta-Facet-Cyst. We point out diagnostical aspects, possible concomitant problems and deriving therapeutical consequences. Between 01. 01. 1998 and 31. 03. 2001 9 patients were operated on a synovial cyst or a ganglion of the facet joint at our department. 5 patients were female, 4 patients male with a mean age of 61 (45-70) years. The average clinical and radiological follow up was 11 (5-18) months postoperatively. The clinical examination revealed in 5 out of 9 patients a sensible deficit, in 3 out of 9 patients motoric disturbances. There was no positive sign of Lasegue. The resection of the cyst or ganglion was performed in all cases via a dorsal approach. 8 patients underwent for a spinal stenosis and/or an existing instability a laminectomy and a spondylodesis with an internal fixateur. The histological findings showed a synovial cyst in 6 cases and a ganglion cyst in 3 cases. At the follow up all preoperative sensible or motorical deficits had resolved. Juxta-Facet-Cysts are discovered in some cases intraoperatively by chance, the radiological methods (CT, MRT) are especially in case of a concomitant spinal stenosis uncertain. During all operations, which are performed for a spinal stenosis, one should look for a cyst. The resection of the cyst leads to good functional results, a possible instability should by addressed by a spondylodesis.

摘要

本研究展示了腰椎关节突囊肿患者手术治疗后的结果。我们指出了诊断方面、可能伴随的问题以及由此得出的治疗结果。1998年1月1日至2001年3月31日期间,我们科室对9例关节突关节滑膜囊肿或腱鞘囊肿患者进行了手术。其中女性5例,男性4例,平均年龄61岁(45 - 70岁)。术后平均临床及影像学随访时间为11个月(5 - 18个月)。临床检查发现,9例患者中有5例存在感觉障碍,9例中有3例存在运动障碍。拉塞格征无阳性表现。所有病例均通过后路切除囊肿或腱鞘囊肿。8例因合并椎管狭窄和/或存在脊柱不稳而行椎板切除术及脊柱融合内固定术。组织学检查结果显示,6例为滑膜囊肿,3例为腱鞘囊肿。随访时,所有术前的感觉或运动障碍均已消失。关节突囊肿在某些情况下是术中偶然发现的,放射学检查方法(CT、MRI)在合并椎管狭窄时尤其难以确定。在所有因椎管狭窄进行的手术中,都应留意囊肿。囊肿切除可带来良好的功能结果,对于可能存在的脊柱不稳应行脊柱融合术。

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