Park Youn-Kwan, Kim Joo Han, Chung Hung Seob, Suh Jung Keun
Department of Neurosurgery, Korea University Guro Hospital, Seoul, Korea.
J Neurosurg. 2003 Apr;98(3 Suppl):264-70. doi: 10.3171/spi.2003.98.3.0264.
When performing surgery, the extraforaminal window is very narrow at the L5-S1 level. The authors describe a microsurgical method for decompression of the L-5 nerve root trapped between a marginal osteophyte of the vertebral body and the transverse process. The procedure was performed in 16 patients with extraforaminal stenosis.
The cranial part of the L5-S1 facet joint and the caudal portion of the pedicle and transverse process of L-5 were removed via a midline skin incision and partial resection of the pars interarticularis; a high-speed drill was used as was a surgical microscope. The affected nerve root was decompressed and mobilized cranially. Postoperatively all patients reported excellent relief of their sciatic pain, and there were no technique-associated complications. There was no recurrence during the follow-up period, that ranged from 14 to 70 months.
The authors recommend this technique for the effective decompression of symptomatic extraforaminal L5-S1 stenosis. The need for a dangerous and tedious removal of the vertebral osteophyte together with spinal fusion is avoided.
在进行手术时，L5 - S1水平的椎间孔外窗口非常狭窄。作者描述了一种显微外科手术方法，用于对被困在椎体边缘骨赘和横突之间的L5神经根进行减压。该手术应用于16例椎间孔外狭窄患者。
通过中线皮肤切口和部分关节突间部切除，去除L5 - S1小关节的头侧部分以及L5椎弓根和横突的尾侧部分；使用高速钻和手术显微镜。对受影响的神经根进行减压并向头侧游离。术后所有患者均报告坐骨神经痛得到显著缓解，且无技术相关并发症。随访期为14至70个月，期间无复发。
作者推荐该技术用于有症状的L5 - S1椎间孔外狭窄的有效减压。避免了危险且繁琐的椎体骨赘切除及脊柱融合术。
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