胸椎及高位腰椎间盘突出的手术治疗

Operative treatment of thoracic and upper lumbar disc herniation

目的探讨胸椎及高位腰椎间盘突出的手术治疗方法及效果。方法回顾分析2006年7月至2011年7月间我院23例患者临床资料。手术采用全椎板切除侧后方入路9例，侧前方入路8例，胸腔镜下手术6例。结果所有患者均随访1—5年。根据Otani’s等分级方法评价：优12例，良9例，一般2例，手术优良率为91．3％。结论胸椎及高位腰椎间盘突出手术方式多且手术难度大，应根据患者的个体情况及发病节段，选择合适的手术方式。

Objective To study the operative treatment of thoracic and upper lumbar disc hernia- tion. Methods The clinical data of 23 cases with thoracic and upper lumbar disc herniation undergoing laminectomy and transversoarthropediculectomy from July 2006 to July 2011 in our hospital were retrospec- tively reviewed, including 9 eases of postemlateral approach,8 cases of anterolateral approach and 6 cases of thoracoscopic approach. Results The follow-up period was from 1 to 5 years. According to the Otani scoring system, 12 cases were excellent,9 eases were good,2 case were average and the excellent-good rate was 91.3%. Conclusion The surgical procedure of thoracic and upper lumbar disc herniation is both complicated and difficult. Individual situation and the level of the disc herniation will influence the choice of surgical procedure.