后路椎间盘镜下椎间盘切除术及其拓展应用

Application and expanding of microendoscopic discectomy via posterior lamina

目的探讨后路椎间盘镜（MED）下椎间盘突出髓核摘除、Cage椎间融合，治疗腰椎间盘突出并退变性腰椎不稳的手术疗效。方法本组11例11间隙腰椎间盘突出并退变性腰椎不稳，其中第4～5腰椎6例，第5腰椎～第1骶椎5例。所有患者术前行x线、CT或MRI检查，手术方式为后路椎间盘镜下椎间盘突出髓核摘除术，然后行Cage椎间融合术。结果11例患者均获成功，术后随访6—36个月（平均18个月）椎间隙高度保持良好，椎间融合器位置良好；1例融合器塌陷，10例植骨获融合，无感染、血肿、神经功能损伤及融合器脱落等其他并发症。结论后路椎间盘镜下椎间盘突出髓核摘除、Cage椎间融合治疗腰椎间盘突出并退变性腰椎不稳是一种创伤小、安全性高、效果好的手术方式。

Objective To explore the effects of nucleocectomy and intervertebral cage for intervertebral disk herniation with lumbar degenerative instability under microendoseopic system. Methods Eleven patients were treated with nucleocectomy and intervertebral cage under microendoscopic system, among which 6 cases in L4/5, 5 cases in L/S1. Every patients underwent the X - ray film, CT or MRI scan. Results All cases were followed up for 6 to 36 months （average 18 months） , and the results showing the height of intervertebral space was maintained, interverbral cage subsided in one case, 10 cases achieved solid bony fusion, and neither cage shift or escape nor neurclogical injury was found. Conclusions Nucleoceetomy and intervertebral cage for intervertebral disk herniation with lumbar degenerative instability under mieroendoseopic system is a good technique, which could achieve satisfactory clinical results with safe and less injury.