后路椎间盘镜治疗腰椎间盘突出症临床研究

Clinical Study on Posterior Approach Microendoscopic Discectomy for Treatment of Lumbar Disc Herniation

目的探讨后路椎间盘镜治疗腰椎间盘突出症的疗效、手术适应征及技巧。方法对本科2002年1月-2006年12月共收治的36例腰椎间盘突出症患者采取后路椎间盘镜的手术治疗方法,采用NaKai标准对病人术后疗效进行评定。结果所有患者均顺利完成手术,有1例患者发生脑脊液漏,1例神经根损伤,无大血管损伤、椎间隙感染等其它并发症发生;随访12～36个月,平均24个月,功能恢复优良率达91.67%。结论后路椎间盘镜治疗腰椎间盘突出症具有损伤小、恢复快、疗效肯定、并发症少等优点,是治疗腰椎间盘突出的较好方法,熟练掌握操作要点和适应证是手术成功的保证,值得临床推广。

Objective To evaluate the posterior approach to lumbar vertebral disc herniation by microendoscopic discectomy. Methods Thirty - six patients with lumbar disc herniation were posterior approached with microendoscopic discectomy from January, 2002 through December, 2006 and the outcomes were evaluated according to the NaKai standards. Results All the patients were successfully completed the surgical procedure. The complications included l cerebrospinal fluid leak and l nerve root injury. Neither infection nor major vascular injury and other complications occurred. Followed- up from 12 to 36 months, average 24 months, demonstrated that the functional recovery excellent rate was 91.67%. Conclusions Posterior approach microendoscopic discectomy for lumbar disc herniation have the advantages of minimal invasive surgical procedures, quicker recovery, definite effectiveness, and fewer complications, which is valid in treatment of lumbar disc herniation. The predominant factors for successful operation are skilled surgical technique and indication. Posterior approach mi- croendoscopic discectomy for lumbar disc herniation is worthy to be recommended clinically.