Yamasaki Yuhei, Tezuka Fumitake, Yamashita Kazuta, Takata Yoichiro, Sakai Toshinori, Maeda Toru, Sairyo Koichi
Department of Orthopedics, Tokushima University, Tokushima, Tokushima, Japan.
NMC Case Rep J. 2019 May 25;6(3):79-81. doi: 10.2176/nmccrj.cr.2017-0213. eCollection 2019 Aug.
We describe here a patient diagnosed with multiple loose bodies in the lumbar facet joint. The patient was a 52-year-old woman who presented with left sciatic pain. Neurological findings indicated L5 radiculopathy. Radiological findings revealed lateral recess stenosis at the L4-L5 level, and loose bodies in the left L4-L5 facet joint were noted that compressed the left L5 nerve root. We performed laminotomy at the left L4-L5 level, and removed five loose bodies located on the dorsal side of the ligamentum flavum. Following removal of the loose bodies and flavectomy, the L5 nerve root was decompressed. Postoperatively, the patient's symptoms improved markedly. Symptomatic multiple loose bodies in the lumbar facet joint are very rare, and can cause lumbar radiculopathy. It is important for spine surgeons to recognize this pathology.
我们在此描述一名被诊断为腰椎小关节内多个游离体的患者。该患者为一名52岁女性，表现为左侧坐骨神经痛。神经学检查结果提示L5神经根病。影像学检查结果显示L4-L5水平侧隐窝狭窄，且发现左侧L4-L5小关节内有游离体，压迫左侧L5神经根。我们在左侧L4-L5水平进行了椎板切开术，并取出了位于黄韧带背侧的五个游离体。取出游离体并切除黄韧带后，L5神经根得到减压。术后，患者症状明显改善。腰椎小关节内有症状的多个游离体非常罕见，可导致腰椎神经根病。脊柱外科医生认识到这种病理情况很重要。
