局麻下侧卧位后路脊柱镜下腰椎间盘切除266例

Microendoscopic Dissectomy in Treatmeat of 246 Patients under Local Anesthesia and Lateral Position

目的 总结局麻下侧卧位MED手术治疗腰椎间盘突出症的效果.方法 2002年4月-2005年11月采用局麻下侧卧位显微椎间盘镜髓核摘除术266例,全为单间隙突出者合并侧陷窝狭窄者72例.突出间隙L3～4 11例,L4～5 98例,L5～S1 157例.突出位置：后外侧型183例,中央型78例,极外侧型5例.结果 所有病例均获得3～18个月的随访,平均7.5个月.优228例,良34例,可4例,差0例,无术后椎间盘炎、复发、神经根损伤者.结论 局麻下侧卧位MED手术是具有手术损伤小,出血少,恢复快的有效方法之一.

Objective To introduce microendoscopic dissectomy （MED） in the treatment of lumbar disc herniation under local anesthesia and lateral position. Methods A total of 246 patients of lumbar disc herniation were operatedd with MED under local anesthesia and lateral position. They were all ill with single disc herniation, including 61 cases with lateral recess stenosis, 11 with L3-4,98 with L4-5 , and 157 with Ls-St herniation. There were 183 cases with post lateral disc herniation, 78 cases with centel disc herniation and five cases with far lateral disc herniation. Results All the patients were followed up 3 ～18 months （ averaging 7.5months） , with the results of excellent in 228 ones, good in 34 ones, so-so in four ones, and unsuccessful in none. The rate on excellent and good was 98.5%, and meanwhile there was no one with disc infection, recurrence and nerve root injury in this group. Conclusion MED has the advantages of minimal invasion, little blood loss and rapid recovery, and it is an effective therapeutic approach to lumbar disc herniation.