Epstein J A, Epstein B S, Lavine L S, Carras R, Rosenthal A D
J Neurosurg. 1976 Feb;44(2):139-47. doi: 10.3171/jns.1976.44.2.0139.
Twenty patients treated for degenerative spondylolisthesis with an intact neural arch principally at the L4-5 interspace had neural compression caused by dislocation of the vertebral bodies and intrusions of lamina and enlarged, arthrotic facets into a stenotic spinal canal. The resulting "pincer" effect caused complete or partial block demonstrable on myelography, with nerve root and cauda equina compression. Most of the patients were women aged 45-84 years. Seven had neurogenic claudication. The majority had unrestricted straight-leg raising, and no signs of acute neural entrapment were seen as in patients with a herniated disc. Absent ankle reflexes, and weakness and atrophy of the anterior tibial muscle group were common, while sensation was relatively undisturbed. Treatment consisted of liberal laminar decompression including foraminotomy and medial or total facetectomy. Good-to-excellent results were obtained, and no patient was made worse by the procedure.
20例主要在L4 - 5间隙神经弓完整的退变性腰椎滑脱患者，其神经受压是由椎体脱位、椎板侵入以及增生的关节突进入狭窄的椎管所致。由此产生的“钳夹”效应在脊髓造影上表现为完全或部分阻塞，并伴有神经根和马尾神经受压。大多数患者为45 - 84岁的女性。7例有神经源性间歇性跛行。大多数患者直腿抬高不受限，且未出现像椎间盘突出症患者那样的急性神经卡压体征。踝反射消失以及胫前肌群无力和萎缩较为常见，而感觉相对未受影响。治疗包括广泛的椎板减压，包括椎间孔切开术和内侧或全关节突切除术。取得了良好至极好的效果，且没有患者因该手术而病情恶化。
