[ 會員#26600 ] au
腰痛腿無力
病患者男 - 29歲
9月時地下濕滑滑倒後， 一開始只是輕微的腰痛，右腳少少無力。過兩日後， 行幾步路已經無力到要停一停休息，開始麻痺。 接受了物理治療及食消炎止痛藥1個月，起初有少少見效，右腳只是間歇性的麻痺， 後來已經無什麼見效了。2年前， 曾經做過L5/S1腰椎間盤切除手術。
磁力共振報告：
The conus medullaris is normal in signal intensity and ends at L1 level. The lumbosacral spine is anatomic in alignment with normal lordosis. The lumbosacral spine vertebral bodies are normal in height. A small focal bony defect at right L5/S1 posterior arch is noted, suggestive of postoperative change. Desiccation of L5/S1 intervertebral disc with mild reduced intervertebral disc height is seen. Small peripheral lumbar vertebral osteophytes and mild bilateral lower facet joint osteoarthritic changes are present. Findings are suggestive of mild background degenerative changes. A small focal T2W hyperintense signal is noted at posterior annulus of L5/S1 intervertebral disc, suggestive of a small annular tear. At L4/L5 level, mild bilateral posterolateral posterior disc protrusion is noted. The central spinal canal and lateral recesses are patent. Mild bilateral neural foraminal stenoses are seen. At L5/S1 level, mild posterior disc bulge with indentation of anterior thecal sac is noted. The posterior annulus of the L5/S1 disc appears slightly irregular, probably postoperative change. The central spinal canal, lateral recesses and neural foramina are patent.
報告顯示應該是輕微的，但為何到現在都差不多3個月，都沒有什麼再有進展，右腿依然會走一段少路已經無力、酸痛，腰痛持續，是否不會完全康復？
9月時地下濕滑滑倒後， 一開始只是輕微的腰痛，右腳少少無力。過兩日後， 行幾步路已經無力到要停一停休息，開始麻痺。 接受了物理治療及食消炎止痛藥1個月，起初有少少見效，右腳只是間歇性的麻痺， 後來已經無什麼見效了。2年前， 曾經做過L5/S1腰椎間盤切除手術。
磁力共振報告：
The conus medullaris is normal in signal intensity and ends at L1 level. The lumbosacral spine is anatomic in alignment with normal lordosis. The lumbosacral spine vertebral bodies are normal in height. A small focal bony defect at right L5/S1 posterior arch is noted, suggestive of postoperative change. Desiccation of L5/S1 intervertebral disc with mild reduced intervertebral disc height is seen. Small peripheral lumbar vertebral osteophytes and mild bilateral lower facet joint osteoarthritic changes are present. Findings are suggestive of mild background degenerative changes. A small focal T2W hyperintense signal is noted at posterior annulus of L5/S1 intervertebral disc, suggestive of a small annular tear. At L4/L5 level, mild bilateral posterolateral posterior disc protrusion is noted. The central spinal canal and lateral recesses are patent. Mild bilateral neural foraminal stenoses are seen. At L5/S1 level, mild posterior disc bulge with indentation of anterior thecal sac is noted. The posterior annulus of the L5/S1 disc appears slightly irregular, probably postoperative change. The central spinal canal, lateral recesses and neural foramina are patent.
報告顯示應該是輕微的，但為何到現在都差不多3個月，都沒有什麼再有進展，右腿依然會走一段少路已經無力、酸痛，腰痛持續，是否不會完全康復？
錢炳航醫生回覆: [ 12/11/2021 ]
謝謝來信，你是根據磁力共振的影像，假設病狀成因是椎間盤突出壓到神經才做手術的，而你腿上的乏力和痳痺 ，卻不一定源於，或只源於椎間盤突出，参考你手術治療後的症狀，應再努力找出其他致病原因，如腿上肌肉，關節等的病變也常'是肢體乏力和痳痺的原因，應讓骨科醫生再詳細檢查，把忽略的病灶找出來，對症下討，應可改善你的症狀。
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