Epstein N E, Syrquin M S, Epstein J A, Decker R E
Department of Surgery, North Shore University Hospital, Manhasset, NY.
J Spinal Disord. 1990 Dec;3(4):396-403.
The clinical, neuroradiological, and surgical management of three cases of intradural disc herniations--one each in the cervical, thoracic, and lumbar regions--are presented. Intradural disc herniations comprise only 0.27% of all herniated discs. Three percent occur in the cervical, 5% in the thoracic, and 92% in the lumbar spinal canal. Those with cervical or thoracic lesions frequently exhibit profound myelopathy, whereas those with lumbar lesions demonstrate radicular or cauda equina syndromes. Although varying combinations of the MRI, non-contrast CT, myelogram, and myelo-CT scans may at times fail to accurately establish the diagnosis of an intradural disc herniation prior to surgery, the index of suspicion raised by the lack of clinical correlation with surgical findings justifies an intradural exploration.
本文介绍了3例硬膜内椎间盘突出症的临床、神经放射学及手术治疗情况，其中颈椎、胸椎和腰椎各1例。硬膜内椎间盘突出症仅占所有椎间盘突出症的0.27%。3%发生于颈椎管，5%发生于胸椎管，92%发生于腰椎管。颈椎或胸椎病变者常表现为严重的脊髓病，而腰椎病变者则表现为神经根或马尾综合征。尽管有时MRI、非增强CT、脊髓造影及脊髓CT扫描的不同组合可能无法在手术前准确诊断硬膜内椎间盘突出症，但临床与手术结果缺乏相关性所引发的怀疑指数足以证明进行硬膜内探查是合理的。
