Nnamdi Ibe Michael Onwuzuruike
Department of Suergery, Central Medicare, Owerri, Imo State, Nigeria.
Niger Med J. 2013 Sep;54(5):339-43. doi: 10.4103/0300-1652.122363.
The pattern of distribution of surgically treated symptomatic prolapsed lumbar and sacral intervertebral discs has been published, though scantily, especially in males. We decided to look at our own series, compare and contrast ours with some of those published.
We treated 88 locations of this lesion in 68 males. The clinical features were those of lower back pains, with or without radiation into the lower extremities, sensory loss and paresis of the limbs. There was a case of loss of urinary bladder and ano-rectal control. All lesions were confirmed through cauda-equinograms and treated under general anaesthesia in knee-chest position (MECCA position). The patients were followed up for 3-6 months post-operatively.
There were 88 locations in 68 males of 21-70 years of age, with 29 prolapses occurring during the age range 31-40 years, while 54 locations were on the left and 48 at L4/5. The procedures were well tolerated by all patients and there were no post-operative complications.
This lesion in our series occurred mostly on the left, at the L4/5 level and peaked at 31-40 years age range. The predictability of occurrence of this disease, using side, level and age is still not feasible in males from our series.
关于经手术治疗的有症状的腰骶部椎间盘突出的分布模式已有报道,尽管报道较少,尤其是关于男性患者的。我们决定研究我们自己的病例系列,并与已发表的部分病例系列进行比较和对照。
我们对68例男性患者的88个病变部位进行了治疗。临床特征为下背部疼痛,伴有或不伴有下肢放射痛、感觉丧失和肢体麻痹。有1例出现膀胱和肛门直肠控制功能丧失。所有病变均通过马尾造影得以确诊,并在全身麻醉下于膝胸位(麦加体位)进行治疗。术后对患者进行了3至6个月的随访。
68例年龄在21至70岁之间的男性患者共有88个病变部位,其中29个突出发生在31至40岁年龄段,54个病变部位在左侧,48个在L4/5节段。所有患者对手术的耐受性良好,且无术后并发症。
在我们的病例系列中,这种病变大多发生在左侧、L4/5节段,且在31至40岁年龄段达到高峰。在我们的男性病例系列中,根据部位、节段和年龄来预测这种疾病的发生仍然不可行。