腰椎间盘髓核摘除术改良研究及应用效果

Improved resection of nucleus pulposus of intervertebral disc the study and use

目的探讨改良腰椎间盘摘除术的应用。方法改良技术包括:①全程引导标记准确定位;②垂直一刀切;③黄韧带外咬椎板;④潜行减压;⑤椎管内静脉前丛“由内向外”推剥;⑥病变间隙充分浸泡冲洗;⑦硬膜外立体抗粘连屏障;⑧局部抗炎。结果接受该改良术式的80例患者无定位错误、切口小、术中出血量少、术后3d腰腿痛程度显著减轻。术后随访60例,优45例、良8例、可5例、差2例,优良率88.3%。结论改良技术可以进一步提高腰椎间盘摘除术的疗效。对部分方法、步骤进行改进后可收到满意效果。

Objective To probe into the use of improved resection of nucleus pulposus of intervertebral disc. Method Author improved the primary resection operation in 7 aspects, and used the improved procedure in 80 cases (male, 53 female, 27) from June, 1998 to March, 2003. Results On the course the improved operation was performed with smaller incision, less bleeding, and without localization error, later 3 days after the operation their pain extents of lower back and legs were significantly relieved. The postoperative follow-ups of 60 cases showed excellent, 45 cases good, 8 cases fair, 5 cases excellent & good rate, 88.3%. Conclusion The improved operation may further raise the response of previous ones.