Kushniruk P I, dreval' O N
Zh Vopr Neirokhir Im N N Burdenko. 2006 Jan-Mar(1):13-7; discussion 17-8.
The study was undertaken to provide an anatomic and morphological rationale for the use of medial facetectomy in the microsurgical treatment of herniated lumbar disks and to assess the results of performed operations. Morphological studies were conducted on corpses, by comparing coronal and transverse sections of the lumbar spine. The concept "nervous root canal" was used during the study. The detected features of the anatomical and topographic structure of the nervous root canal permitted the substantiation of the necessity and volume of medial facetectomy at different levels. When an approach is applied into the discal area, the highest and least volume of bone resection at medial facetectomy is required at the levels of L3-L4 and L5-S1, respectively. The clinical study involved an analysis of the results of microsurgical treatment of 530 patients with herniated lumbar disks. The analysis of clinical findings revealed that medial facetectomy had been used during 382 (72%) operations. When the operations were performed at different levels, the usage of this technique differs: at the levels of L3-L4, L4-L5, and L5-S1 in 30 (100%), 206 (91%), and 145 (53%) cases, respectively. The data on the usage of medial facetectomy during operations correspond to the revealed specific features of the anatomic and topographic structure of the nervous root canal at each of the operated levels.
本研究旨在为腰椎间盘突出症显微手术中使用内侧小关节切除术提供解剖学和形态学依据，并评估所施行手术的结果。通过比较腰椎的冠状面和横断面，对尸体进行形态学研究。研究过程中使用了“神经根管”这一概念。神经根管解剖和地形结构的检测特征证实了不同节段内侧小关节切除术的必要性和切除范围。当采用进入椎间盘区域的入路时，L3-L4和L5-S1节段内侧小关节切除术所需的骨切除量分别为最高和最低。临床研究包括对530例腰椎间盘突出症患者显微手术治疗结果的分析。临床结果分析显示，382例（72%）手术中使用了内侧小关节切除术。当在不同节段进行手术时，该技术的使用情况有所不同：在L3-L4、L4-L5和L5-S1节段分别为30例（100%）、206例（91%）和145例（53%）。手术中内侧小关节切除术的使用数据与每个手术节段神经根管解剖和地形结构的特定特征相符。
