Lumbar disk herniation with contralateral symptoms
Lumbar disk herniation with contralateral symptoms
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DOI：
10.1007/s00586-005-0971-x
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发表时间：
2006-05-01
影响因子：
2.8
通讯作者：
Gelal, F
中科院分区：
文献类型：
--
作者：
Sucu, HK;Gelal, F
本研究的目的是确定是否对侧腰椎间盘突出症可引起下肢疼痛，以及仅从突出侧进行干预是否足以治疗这些患者。5例腰椎间盘突出症患者，主要是对侧症状，从椎间盘突出侧手术，而不探索或减压症状侧。术前和术后对患者进行评价。据我们所知，这是第一个报道的系列这样的病人谁是手术只从疝侧。对侧症状在这些患者中占主导地位的可能机制也进行了讨论。在所有患者中，椎间盘突出的影像学表现都非常相似：广泛的后中央-旁中央椎间盘突出，突出点偏离症状侧。症状和体征在术后即刻消退。我们的数据清楚地表明坐骨神经痛可以由对侧腰椎间盘突出症引起。当考虑手术时，仅从疝侧进行干预就足够了。对侧症状的出现可能是由于牵引而不是直接压迫。
The aim of the study is to determine if leg pain can be caused by contralateral lumbar disk herniation and if intervention from only the herniation side would suffice in these patients. Five patients who had lumbar disk herniations with predominantly contralateral symptoms were operated from the side of disk herniation without exploring or decompressing the symptomatic side. Patients were evaluated pre- and postoperatively. To our knowledge, this is the first reported series of such patients who were operated only from the herniation side. The possible mechanisms of how contralateral symptoms predominate in these patients are also discussed. In all patients, the shape of disk herniations on imaging studies were quite similar: a broad-based posterior central-paracentral herniated disk with the apex deviated away from the side of the symptoms. The symptoms and signs resolved in the immediate postoperative period. Our data clears that sciatica can be caused by contralateral lumbar disk herniation. When operation is considered, intervention only from the herniation side is sufficient. It is probable that traction rather than direct compression is responsible from the emergence of contralateral symptoms.