腰椎间盘突出微创手术治疗研究进展

Study on minimally invasive surgery for lumbar disc herniation

腰椎间盘突出症(LDH)被定义为中央的椎间盘(髓核)突出,LDH手术是脊柱外科最常见的手术之一。有症状的LDH的手术可以分为开放式手术与内镜手术。经皮内窥镜腰椎间盘切除术(PELD)主要有两种入路,即经椎间孔入路的经皮椎间孔镜椎间盘切除术(PETD)和经椎板间入路的经皮内窥镜椎间盘切除术(PEID)。椎间融合术有微创经椎间孔腰椎椎间融合术(MIS-TLIF)、微创侧方腰椎椎间融合术(MIS-LLIF)等。本文从LDH微创手术的发展史、临床治疗效果、适应证、禁忌证及并发症等方面来论述国内外近五年来的研究进程,并探索LDH在微创手术治疗的新方向。

Lumbar disc herniation(LDH)is defined as central disc(nucleus pulposus)herniation,and 90%of the patients have nerve root symptoms.Surgery for LDH is one of the most common operations in spinal surgery.Symptomatic LDH can be treated with open surgery and endoscopic surgery.There are two main approaches to percutaneous endoscopic lumbar discectomy(PELD),namely the percutaneous endoscopic transforaminal discectomy(PETD)and percutaneous endoscopic interlaminar discectomy(PEID).Interbody fusion includes minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF),minimally invasive lateral lumbar interbody fusion(MIS LLIF),and so on.In this paper,the development history,clinical treatment effect,indications,contraindications and complications of LDH minimally invasive surgery were reviewed in recent five years,and the new direction of LDH minimally invasive surgery was explored.