经皮穿刺切割椎间盘治疗腰椎间盘突出症

Percutaneous Lumbar Discectomy Treating Lumbar Disc Herniation

目的探讨经皮穿刺切割椎间盘治疗腰椎间盘突出症的临床效果及安全性。方法经ＣＴ或ＭＲＩ确诊后的４２例病人在ＤＳＡ下应用国产ＺＣ－Ⅰ或Ⅱ切割器在局麻下取侧卧位或俯卧位穿刺切割椎间盘。结果（１）优：疼痛消失无运动受限，恢复正常活动２７例，（２）良：偶有轻度疼痛，能做轻微工作，生活能自理１０例，（３）可有些改善，但仍有疼痛，不能参加工作３例。（４）差：有神经受压表现需进一步手术治疗。优良率为８８％。结论ＰＬＤ术创伤小、出血少痛苦少、恢复快，不造成神经根粘连和硬膜纤维化，不影响脊柱的稳定性，该方法安全可靠，操作简单，是目前治疗腰椎间盘突出症的一种较为理想的方法。

Objective To investigate the clinical efficacy and safety of PLD in the treatment of lumbar disc herniation. Method 42 cases diagnosed by CT or MRI received PLD in lateral decubitus or ventral decubitus by using ZC Ⅰ or ZC Ⅱ cutter made in China under the digital substractive angiographic machine. Results According to Macnab standard all cases were divided into: (1)Excellent: no pain, no dyskinesis, and restoration of normal activity (27 cases), (2)Good: occasional slight pain, capable of doing some light works, self dependent in daily life (10 cases). (3)Improved: less pain and unable to work (3 cases). (4)Poor: There are symptoms of compressed nerve root need f*rther operation. The rate of excellent and good were 88%. Conclusion PLD has the advantage of less trauma and hemorrhage, slight pain, rapid recovery, leaving no nerve root adherence and dural fibrosis and no affection to the stability of spinal column. It is relatively safe and is a simple procedure and more ideal method for the treatment of lumbar disc herniation.