The diagnosis and treatment of lumbosacral extra-canal nerve root entrapment
10.3760/cma.j.cn121113-20240324-00166
- VernacularTitle:腰骶椎管外神经根卡压症的诊断和治疗策略
- Author:
Baoshan XU
1
;
Xinlong MA
Author Information
1. 天津医院微创脊柱外科，天津 300211
- Keywords:
Intervertebral disc displacement;
Lumbosacral vertebrae;
Nerve compression;
Endoscopy
- From:
Chinese Journal of Orthopaedics
2024;44(19):1313-1318
- CountryChina
- Language:Chinese
-
Abstract:
In recent years, with the advancement of diagnostic and treatment technology, lumbosacral extra-canal nerve root entrapment has gradually attracted attention. Patients often have hypertrophy of the transverse process, high iliac spine, proliferation of the articular process joints and iliopsoas ligaments, and extreme lateral herniation of the intervertebral disc, mostly classified as type 1-2 in the lumbosacral triangle, because of which misdiagnosis is not uncommon in clinic. Diffusion tensor imaging and magnetic resonance neurography can display the compressed nerve root. The main purpose of surgical treatment is to fully relieve nerve compression and thus appropriate surgical techniques should be selected based on the site of compression and the classification of the lumbosacral triangle, including paraspinal or Wiltse approach TLIF, micro foraminotomy, and endoscopic decompression. Direct introduction of a co-axis endoscopic tube into the narrow space may compress or damage the nerve root; while foramen fenestration or extra-foraminal biportal endoscopy can be used to sufficiently decompress the nerve root with floating tube.
