显微内窥镜下腰椎间盘切除术操作要点及并发症防治

Operation Skills and Complications Prevention of Microendoscopic Discectomy

目的探讨显微内窥镜下腰椎间盘切除术治疗腰椎间盘突出症手术操作技巧。方法回顾分析2003年9月-2007年8月治疗的236例腰椎间盘突出症患者的临床资料，总结手术操作经验及并发症发生情况。结果疗效按照改良的Macnab标准评定：优143例，良81例，可7例，差5例；优良率94．9％。疗效差的包括椎间隙感染2例，症状无改善2例，术后死亡1例。结论熟练掌握手术操作技巧，严格选择适应证是保证手术疗效的关键，并发症的防治应引起重视。

Objective To discuss the operation skills of microendoscopic diseectomy （MED） for lumbar disc herniation. Methods Clinical data of 236 patients with lumbar disc herniation from September 2003 to August 2007 were analyzed, and experiences and Surgical complications were summarized. Results According to the improved Macnab standards, 143 cases had gifted effect,81 cases good,7 cases acceptable,and 5 cases poor,with a fine rate of 94. 9 percent. For the cases with poor effect, 2 cases had Vertebral space infection,2 cases showed no symptom improvement and 1 case died after operation. Conclusion Good surgical skills and strict indication selection are the keys for the treatment of lumber disc herniation. The prevention and treatment of complications should also be paid attention to.