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由L5-S1前方骨赘压迫L5神经根导致的L5神经根病。

L5 radiculopathy caused by L5 nerve root entrapment by an L5-S1 anterior osteophyte.

作者信息

Jones Thomas Louis, Hisey Michael S

机构信息

Texas Back Institute Research Foundation, Plano, TX.

Texas Back Institute, Denton, TX.

出版信息

Int J Spine Surg. 2012 Dec 1;6:174-7. doi: 10.1016/j.ijsp.2012.05.001. eCollection 2012.

DOI:10.1016/j.ijsp.2012.05.001
PMID:25694887
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4300884/
Abstract

BACKGROUND

L5 radiculopathy is a common problem that has several causes. Entrapment of the L5 nerve root by anterior osteophytes at the L5-S1 junction is rarely reported. Posterior decompression of the L5 nerve root is commonly performed, but anterior decompression of the L5 nerve root is not a frequently performed procedure. The purpose of this case report is to describe an uncommon case of L5 radiculopathy caused by the entrapment of the L5 nerve root by an anterior osteophyte.

METHODS

We report the case of a 79-year-old man with a right lower extremity L5 radiculopathy causing excruciating pain, worsening with transitioning between seated and standing positions. Radiologic evaluation showed a large osteophyte coming off of the right anterolateral border of L5-S1. The osteophyte was excised through a right-sided anterior retroperitoneal approach. An anterior interbody fusion was performed at L5-S1.

RESULTS

Postoperatively, the patient's pain was completely resolved. Six months after surgery, he remained symptom free.

CONCLUSIONS

Osteophytes at the L5-S1 junction can entrap the L5 nerve root. If nonoperative treatment fails, the osteophyte can be excised and the nerve can be safely decompressed through an anterior retroperitoneal approach.

摘要

背景

L5神经根病是一个常见问题，有多种病因。L5 - S1节段前方骨赘压迫L5神经根的情况鲜有报道。L5神经根后路减压术较为常用，但L5神经根前路减压术并非经常实施。本病例报告的目的是描述一例由前方骨赘压迫L5神经根导致的不常见的L5神经根病。

方法

我们报告了一例79岁男性患者，患有右侧下肢L5神经根病，疼痛剧烈，在坐位和站位转换时加重。影像学评估显示，L5 - S1右侧前外侧缘有一巨大骨赘。通过右侧前路腹膜后入路切除骨赘，并在L5 - S1节段进行前路椎间融合术。

结果

术后，患者疼痛完全缓解。术后6个月，他仍无症状。

结论

L5 - S1节段的骨赘可压迫L5神经根。若非手术治疗失败，可切除骨赘，并通过前路腹膜后入路安全地解除神经压迫。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/916a/4300884/f3aefdfc3f07/IJSS-6-2012-05-001-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/916a/4300884/04a5e7063851/IJSS-6-2012-05-001-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/916a/4300884/e8a28b8cc842/IJSS-6-2012-05-001-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/916a/4300884/f3aefdfc3f07/IJSS-6-2012-05-001-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/916a/4300884/04a5e7063851/IJSS-6-2012-05-001-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/916a/4300884/e8a28b8cc842/IJSS-6-2012-05-001-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/916a/4300884/f3aefdfc3f07/IJSS-6-2012-05-001-g003.jpg

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