显微镜下巨大型腰椎间盘突出症的手术治疗

Surgical Treatment of the Huge Lumbar Intervertebral Disc Herniation under Microscope

目的探讨经后路显微镜辅助下椎间盘切除术(microsurgery lumbar discectomy,MSLD)治疗单节段巨大型腰椎间盘突出症的方法与疗效。方法 2008年9月至2012年1月,收治25例单节段巨大型腰椎间盘突出症患者,其中男12例,女13例;年龄15～56岁,平均43岁。均行MSLD辅助下椎板开窗摘除椎间盘手术。结果术后随访6个月～3年(平均1.5年),术后按照Macnab评分进行疗效评定,优18例(72%),良5例(20%),可2例(8%),差0例。术后切口均Ⅰ期愈合。无手术间隙定位错误、神经根损伤、马尾神经损伤及感染等并发症发生。结论 MSLD具有创伤小、安全、并发症少、效果好等优点,是治疗单节段巨大型腰椎间盘突出症的一种理想的微创手术方式。

Objective To explore clinical effect of mierosurgery lumbar discectomy（MSLD） in single segmental huge lumbar intervertebral disc herniation. Methods From September 2008-January 2012, 25 patients with single segmental huge lumbar intervertebral disc herniation were operated under microscope. Results All the patients were followed up for 6 months to 3 years （mean 1.5 years）. Postoperative Macnab score was excellent in 18 cases （72~）, good in 5 cases （20%）,fair in 2 cases（8~） and poor in 0 cases. There were no positioning error,the nerve root in- jury,horsetail nerve injury and infection. Conclusion MSLD has advantagees of small trauma,safety,less complica- tions and the good effect,and it is an ideal method of minimally invasive surgery to treat single segmental huge lumbar intervertebral disc herniation.