腰椎间盘突出术后神经损伤患者 康复1例

A Case of Rehabilitation in a Patient with Postoperative Nerve Injury Following Lumbar Disc Herniation

摘要: 本病例报告分析1例48岁女性腰椎间盘突出症(L4/5、L5/S1节段)患者的临床诊疗及康复过程，该患者行经皮椎间孔镜下椎间盘切除术(PTED)后出现双下肢瘫痪，虽经二次减压手术解除神经压迫，术后仍遗留显著运动功能障碍。患者经过28天药物联合综合康复治疗干预后，其肢体功能逐步恢复，可自主完成关节活动、独自站立并实现辅助行走；肌电图复查结果显示，患者双下肢胫神经、腓总神经的运动传导速度较康复治疗前均有明显提升。本病例的康复转归，进一步印证了早期综合性康复干预在腰椎间盘突出症术后神经根损伤患者中应用的潜在临床价值与实施必要性。

Abstract: This case report presents a 48-year-old female patient who developed paraplegia of both lower extremities following percutaneous transforaminal endoscopic discectomy (PTED) for L4/5 and L5/S1 lumbar intervertebral disc herniation. Despite secondary decompression surgery, the patient persisted with severe motor dysfunction. After 28 days of pharmacotherapy combined with comprehensive rehabilitation interventions, the patient gradually regained the ability of voluntary joint movement, standing and assisted ambulation. Electromyography (EMG) showed that the motor and sensory conduction velocities of the tibial nerves and common peroneal nerves in both lower extremities were increased compared with those before rehabilitation. The rehabilitation effect of this patient underscores the potential value and necessity of early and comprehensive rehabilitation intervention in patients with postoperative nerve root injury due to lumbar intervertebral disc herniation.