腰椎间盘镜下手术置镜定位方法的临床应用

Clinical application of the methods about orientation to set up the endoscope during the microendoscopic discectomy

目的探讨MED技术应用中采用术前划线定位进行置镜的意义。方法对274例腰椎间盘突出患者在MED技术应用中采用术前透视定位(98例)及术前划线定位(176例)两种方法进行术前定位置镜,分别记录两组患者的定位时间、定位准确率、临床疗效等。比较两组患者上述指标的差异。结果划线组定位时间(2.61±0.36)min,定位准确率97.7%;MacNab疗效评定:痊愈148例,显效20例,有效8例,无效0例,优良率95.5%。透视组定位时间(15.96±2.58)min,定位准确率98.0%;MacNab疗效评定:痊愈82例,显效11例,有效5例,无效0例,优良率94.9%。与透视组比较,划线组定位时间明显缩短,差异有统计学意义(P<0.01);定位准确率及临床疗效两组比较差异无统计学意义(P>0.05)。结论术前划线定位省时,经济实用,准确率高,是MED技术应用中可选择的良好定位方法 。

Objective To explore the significance of preoperative lineation orientation to set up the endoscope during the application of the microendoscopic discectomy（MED）.Methods Two methods of preoperative orientation including lineation orientation（176 cases）and perspective orientation（98 cases）to set up the endoscope were alternatively used during the application of the MED technology in 274 cases of lumbar disc herniation.Some data in two groups such as the orientation time,orientation accuracy and clinic outcomes were recorded and compared in order to find the difference between them.Results The orientation time in lineation group and perspective group were（2.61±0.36）min and（15.96±2.58）min,respectively.The orientation accuracy were 97.7% and 98.0%,respectively.The results were excellent in 148 cases,good in 20,fair in 8 and poor in 0 in lineation group,and they were 82,11,5,and 0 in perspective group,respectively.The excellent and good rate by the MacNab outcome evaluation were 95.5% and 94.9%.By comparing the orientation time,orientation accuracy and clinic outcome in two groups,the orientation time in lineation orientation group were shorter than that in perspective orientation group（P0.01）,but the orientation accuracy and clinic outcome in two groups had no significant difference（P0.05）.Conclusions The preoperative lineation orientation to set up the endoscope during the application of the MED is an alterative good method because of it＇s saving time,economic practicality and high accuracy.