Wang Yan, Zhang Xue-song, Zhang Yong-gang, Liu Zheng-sheng, Xiao Song-hua, Liu Bao-wei
Department of Orthopaedics, PLA General Hospital, Beijing 100853, China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2005 Apr;27(2):170-3.
To investigate the factors that may contribute to radiculopathy in degenerative lumbar stenosis with scoliosis (DLSS) and their association with the pattern of the scoliosis.
Twenty-seven patients with DLSS were examined in our hospital. The symptomatic nerve roots were determined by pain distribution, and neurological findings. The compressive factors were diagnosed by magnetic resonance imaging and myelography or radiculography. The pattern of scoliosis was determined by plain radiographs. Correlation between the affected nerve root and the compressive factors or the pattern of the scoliosis were then analyzed.
Among the 27 patients, L3 root was affected in 6 patients, L4 root in 13 patients, L5 root in 15 patients, and S1 root in 9 patients. L3 and L4 roots were more compressed by foraminal or extraforaminal stenosis on the concave side of the curve, whereas L5 and S1 roots were commonly affected by lateral recess stenosis on the convex side.
In DLSS, nerve root compression is not only seen on the concave side of the scoliosis, but also equally involved on the convex side. Most radiculopathy in DLSS distributes close to central sacral vertical line, which may be due to the abnormal weight-bearing for the pattern of scoliosis.
探讨退变性腰椎管狭窄症伴脊柱侧凸（DLSS）中可能导致神经根病的因素及其与脊柱侧凸类型的关系。
对我院27例DLSS患者进行检查。根据疼痛分布和神经学检查结果确定有症状的神经根。通过磁共振成像、脊髓造影或神经根造影诊断压迫因素。通过X线平片确定脊柱侧凸类型。然后分析受累神经根与压迫因素或脊柱侧凸类型之间的相关性。
27例患者中，L3神经根受累6例，L4神经根受累13例，L5神经根受累15例，S1神经根受累9例。L3和L4神经根在侧弯凹侧更易受到椎间孔或孔外狭窄的压迫，而L5和S1神经根通常受到凸侧侧隐窝狭窄的影响。
在DLSS中，神经根受压不仅见于脊柱侧凸的凹侧，凸侧同样受累。DLSS中的大多数神经根病分布靠近骶骨中央垂线，这可能是由于脊柱侧凸类型导致的异常负重所致。
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