经椎板间隙直视下微创手术治疗腰椎间盘突出症

Minimally invasive discectomy through inter-laminar space for the lumbar disc herniation

目的探讨经椎板间隙直视下微创手术治疗腰椎间盘突出症的临床价值和适应证。方法回顾分析我院自1996.2-2001.8经椎板间隙显露法对185例腰椎间盘突出症行髓核摘除及神经根管扩大术的病例。术前患者行腰椎X线检查,测量L5S1及L4-5椎板间隙的面积,对于L4-5椎板间隙的面积>250mm2及L5S1椎板间隙的面积>280mm2的病史短且单纯腰椎间盘突出的患者行经椎板间隙直视下微创髓核摘除术。结果术后对其中的169例进行随访,随访3～38月,平均随访24月,采用1994年中华骨科学会脊柱外科组制定的手术疗效标准,观察评定疗效。优122例,良38例,优良率94.6%。结论合理选择适应证,经椎板间隙髓核摘除术治疗腰椎间盘突出症不仅能迅速减压,消除症状,且几乎不破坏脊柱的稳定性,并发症少,创伤小,恢复快,疗效高。

Objective To investigate a clinical application and indication of the minimally invasive surgery through inter-laminar space for the treatment of lumbar disc herniation(LDH). Methods 185 patient with Lumbar disc herniation treated with minimally invasive discectomy through inter-laminar space were analysed retrospectively from Feb. 1996-Aug.2001 Every patient had lumbar radiographs preoperation. We measured the area of L4-5 and L5S1 laminar space,when the area of L4-5 laminar space more than 250mm2 or L5S1 laminar space more than 280mm2,we treated the patient with minimally invasive discectomy through inter-laminar space.Results 169 patients were followed up after the operation for 3 to 38 months on average. The excellent were 122 patients and good were 38 patients,The excellent and good rate was 94.6%. Conclusion Minimally invasive discectomy through inter-laminar space for the treatment of lumbar disc herniation(LDH) not only can get excellent clinical outcome but also microlesion and less complication and little influence on the stability of the posterior structure of the lumbar vertebrae.