Prestar F J, Schattke H H
Neurosurgical Clinic, Bundesknappschaft, Knappschaftskrankenhaus Bergmannsheil, Gelsenkirchen-Buer, Germany.
Minim Invasive Neurosurg. 1995 Sep;38(3):125-8. doi: 10.1055/s-2008-1053471.
Intradural lumbar disc herniation is a rare pathological entity. Three new cases among a series of 5000 lumbar spine operations are added to the about 60 previous case reports in the literature. None of our patients had undergone lumbar spine surgery before. In one patient the location of the free disc fragment was medial within the dural sac; in two patients the free disc fragment had penetrated the dural sac from the axilla of the nerve root. Pathogenesis is discussed (congenital adhesions of the dura mater to the posterior longitudinal ligament at the lower lumbar spine; weakness of the dura mater ventrally and at the axilla of the nerve root). By multiplanar MRI, the free disc hernia within the dural sac may be shown preoperatively.
硬膜内腰椎间盘突出是一种罕见的病理实体。在一系列5000例腰椎手术中有3例新病例，这使文献中之前约60例病例报告又有所增加。我们的患者之前均未接受过腰椎手术。1例患者游离椎间盘碎片位于硬膜囊内的内侧；2例患者游离椎间盘碎片从神经根腋部穿破硬膜囊。文中讨论了其发病机制（硬脊膜与下腰椎后纵韧带的先天性粘连；硬脊膜腹侧及神经根腋部薄弱）。通过多平面MRI，术前可显示硬膜囊内的游离椎间盘疝。
