微创技术——METRx椎间盘镜手术系统的临床应用

Clinical application of microtraumatic technique－microendoscopic dissectomy system (METRx)

目的 通过介绍METRx椎间盘镜手术系统的临床应用，探讨微创技术在治疗腰椎间盘突出症应用前景。方法 在C臂机定位下，确认椎间盘突出间隙，于脊柱中线旁开1．5cm处取一1．6cm切口，逐级扩张后置入工作通道管及内窥镜，于椎板下缘咬除部分骨质及黄韧带，显露神经根、硬膜囊及突出的椎间盘，行髓核摘除或神经根管扩大减压或切除增生小关节。结果 32例均随访6个月，按Nakai标准疗效评定，优27例，良5例，优良率100％。结论 METRx椎间盘镜手术系统将传统的椎间盘开放手术内窥镜化、微创化。该项技术创伤小、安全可靠，病人痛苦小，恢复快，是微创技术在脊柱外科必然发展趋势。

Objective To investigate the microendoscopic dissecetomy system METRx prospect of application a microtraumatic technigue on treating lumbosacral disc herniation． Methods METRx were performed on 37 patients with lumbar disc herniation LDH． The treating effect was evaluated with Nakai＇s method after operation 6 and 12 months． The operative procedure was the following First position interlaminar space under the ″C″ arm X－ray machine guidancing． Then through an incision 1．6cm in length on the paraspinal 1．5cm off midline sequentially dilate put tubular and endoscope to the inferior edge of the superior lamina wear off part backbone and ligamentum flavum and unfold nerve root dura and disc of herniation． Last remove the nucleus and clean the nerve root canal． Results of 32 patients with LDH followed up 6 to 12 months 27 were evaluated as excellent 5 as good the excellent and good rate was 100％． Conclusion Application of microtraumatic technique is a tendency in spinal surgery METRx has following merits wound smallness security patients affliction soupcon recuperation rapidity．