腰椎关节突囊肿诊断与治疗方式

doi:10.6040/j.issn.1671-7554.0.2019.109

摘要/Abstract

摘要： 目的探讨腰椎关节突囊肿的诊断要点及治疗方式。方法选取2011年12月至2018年4月腰椎关节突囊肿患者12例,其中男5例,女7例,51~68岁,平均59.3岁。对患者病史、体征、影像学表现及治疗方式进行回顾性分析,所有患者均行腰椎正侧位、前屈后伸位平片及CT、MRI等影像学检查,其中2例予以保守治疗,9例行部分关节突关节连同部分椎板间黄韧带切除,以椎板间开窗实现关节突囊肿的完整切除,1例合并滑脱及椎间失稳者行减压融合内固定术。随访6~62个月。结果 MRI图像可明确腰椎关节突囊肿的诊断,患者术后随访时间内效果佳,无复发。结论 MRI检查对于腰椎关节突囊肿的诊断具有重要意义,通过部分关节突关节连同部分椎板间黄韧带切除,实现关节突囊肿完整切除的手术方式是治疗腰椎关节突囊肿的有效手段。

关键词: 关节突囊肿, 滑膜囊肿, 腰椎, 诊断, 治疗, 完整切除

Abstract: Objective To explore the essentials of diagnosis and treatment of lumbar facet cysts. Methods The clinicopathological data of 12 patients with lumbar facet cysts treated during Dec. 2011 and Apr. 2018 were retrospectively analyzed, including history, signs, imaging manifestations, and treatment. The patients included 5 male and 7 female, aged 51-68 years, average 59.3 years. All patients received X-ray inspection in anteroposterior and lateral position and in anterior flexion and posterior extension position and CT and MRI inspection. Two patients received conservative treatment, 9 patients received cyst enbloc resection surgery through partial facet joint with partial interlaminar ligamentum flavum removal, and 1 patient who had spondylolisthesis and intervertebral instability received decompression and internal fixation. All patients were followed up for 6-62 months. Results MRI could conform the specific diagnosis of lumbar facet cysts. No recurrence was observed during the follow-up. Conclusion MRI inspection is important in the diagnosis of lumbar facet cysts. The complete resection of lumbar facet cysts through partial facet joint and partial interlaminar ligamentum flavum removal is an effective treatment.

Key words: Facet cyst, Synovial cyst, Lumbar spine, Diagnosis, Treatment, Complete resection

中图分类号:

R681.5

王海峰,王峰,谭炳毅,韩世杰,徐西强,王大川. 腰椎关节突囊肿诊断与治疗方式[J]. 山东大学学报 (医学版), 2019, 57(5): 56-61.

WANG Haifeng, WANG Feng, TAN Bingyi, HAN Shijie, XU Xiqiang, WANG Dachuan. Diagnosis and treatment of lumbar facet cysts[J]. Journal of Shandong University (Health Sciences), 2019, 57(5): 56-61.

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