摘要
目的:报告微创开放式手术治疗腰椎间盘突出症的效果。方法:为60例腰椎间盘突出症患者实施微创开放式手术,术中用“C”型臂X线机定位,做3~3.5cm长的皮肤切口,剥离椎间的部分骶棘肌,咬除部分椎板上缘及小关节内侧缘后摘除髓核,并根据需要扩大神经根管。结果:本组病例随访2~21(平均11.5)个月,按Nakai标准评定疗效:优45例(75%);良12例(20%);可2例(3.3%);差1例(1.7%)。结论:微创开放式手术治疗腰椎间盘突出症,手术创伤比传统的手术小,手术适应证比椎间盘镜手术宽,而且疗效比较好。
Objective:To report the outcome of minimal invasive open diskectomy to treat lumbosacral disk herniation. Methods: Sixty patients had their herniated disk removed and the nerve root canals decompressed when necessary by the minimal invasive open diskectomy. Through a skin incision 3~3. 5cm in length, a part of the sacrospinalis muscle between the adjacent laminae was stripped off and the upper edge of the lamina and the posterointernal part of the facet were removed. C-arm X-ray intensifier was used for intraoperative supervision. Results:A followe-up from 2 to 21 months (mean 11. 5 months) was done, the evaluation with Nakai scale revealed excellent in 45 cases (75%) , good in 12(20%), fair in 2(3. 3%) , and poor in 1 (1.7%). Conclusions: Minimal invasive open diskectomy can be used to treat lumbosacral disc herniation with satisfactory outcome, had less trauma than ordinary diskectomy and wider indication than microendoscopic diskectomy.