小切口潜行开窗术摘除椎间盘突出远期随访

Small Incision Intervertebral Fenestration Discectomy for Treatment of Lumbar Disc Herniation

采用小切口潜行开窗摘除椎间盘突出1874例,随访5～11年486例,平均8.6年,优良率97％(425例)。采用等动功能测试系统评价开窗摘除椎间盘的远期效果显示对腰椎稳定性破坏小。手术显露范围小,出血少,神经粘连和医源性椎管狭窄机会少。文章讨论了椎间盘突出的早期诊断,手术方法的选择和手术方式对脊柱生物力学的影响,椎间盘摘除术作者首推小切口开窗。

A series of 1874 patients with lumbar disc herniation underwent small-incisional creeping fenestrational discectomy. 486 of these patients were available for follow-up study of 5-11 years (average 8. 6 years). 425 cases (97%)had excellent or good result-s. X-ray examination and Isokinetic Testing System (BIODEX) were used to evaluate the long-term results. It suggested that this method had the advantages of minimal damage to the spinal stability and less bleeding,which reduced the chance of nerve root adhesion and iatrogenic spinal canal stenosis. Early diagnosis of lumbar disc herniation,selection of surgical method and its influence to spinal biomechanics were also discussed.