Diagnosis and treatment of lumbosacral nerve roots anomalies / 中国矫形外科杂志

ABSTRACT

[Objective]To investigate the diagnosis and treatment of lumbosacral nerve roots anomalies. [Method]Etiological factors,typing,diagnosis and treatment of lumbosacral nerve roots anomalies confirmed by operation were analyzed.Operative treatment included wide laminectomy(n=8),hemilaminectomy(n=8) and enlargement fenestration(n=9).[Result]The presenting symptoms of lumbosacral nerve roots anomalies often resulted from lumbar disc herniation or spinal canal stenosis.The typs of lumbosacral nerve roots anomalies included conjoined nerve roots(n=10),closely adjacent roots(n=8),thickening of nerve roots(n=2),caudal origin roots(n=2),division of nerve roots(n=1),double nerve roots(n=1),and anastomosis of nerve roots(n=1).The levels of nerve roots anomalies were L4 in 1,L5 in 14,and S1 in 10.Only 5 cases were diagnosed preoperatively by myelography,CT or MRI.The others were found at operation.All patients were followed up for more than 2 years.Postoperatively,the results were rated as excellent in 12,good in 8,and fair in 4.One patient had residual radiating pain in the lower lims and weakness in dorsiflexion of the foot. [Conclusion] Radicular symptoms of lumbosacral nerve roots anomalies are changeable.The preoperative diagnosis is difficult to establish by myelography,CT or MRI(axial and sagittal plane).It is necessary to heighten the sensitivity of diagnostic modalities.It may improve the surgical outcomes to expose sufficiently,to explore the nerve roots carefully and to decompress thoroughly.