微创开窗手术治疗腰椎间盘突出症

Minimally invasive fenestration operation in treatmeant of prolapse of lumbar intervertebral disc

目的:探讨微创开窗手术治疗腰椎间盘突出症的疗效。方法:收集2007年3月～2010年12月我院腰椎间盘突出患者87例,采用微创小切口椎板开窗法进行腰椎间盘髓核摘除及神经根管减压术,其中,L4～5突出44例,L5～S1突出36例,L3～4突出7例,L4～5和L5～S1双突出12例。结果:所有患者无神经根和硬脊膜损伤,切口一期愈合,腰腿痛症状缓解85例,优良率达97.7%(85/87)。结论:微创开窗手术治疗腰椎间盘突出症,具有创伤小、出血少、恢复快、疗效好、对脊柱稳定性影响小等优点,但是手术成功的前提是术者要有熟练的手术技巧和准确的手术定位。

Objectives： To explore the therapeutic effect of minimally invasive fenestration operation in the treatment of prolapse of lumbar intervertebral disc（PLID）.Methods： 87 cases of patients with PLID were selected from March 2007 to December 2010 in our hospital.Minimally invasive fenestration in vertebrallamina were used for nucleus pulposus excision and nerve root canal decompression.44 cases were prolapsed in L4-5,36 cases in L5-S1,7 cases in L3-4,12 patients were prolapsed in both L4-5 and L5-S1.Results： No nerve root and endorhachis injury were observed.85 cases had healing by first intention and the symptoms of lumbocrural pain were remited with a total excellence rate of 97%（85/87）.Conclusion： Minimally invasive fenestration operation shows the advantage of minimal invasion and bleeding,rapid recovery,good therapeutic effect and slight impact on spinal stability.However,success of the operation is dependent on the surgeon＇s proficient operation skill and accurate surgery positioning.