经脊柱后路显微内窥镜手术治疗腰椎间盘突出症

Microendoscopic discectomy for the treatment of lumbar disc herniation

目的:探讨应用MED治疗腰间盘突出症的临床效果及适应证.方法:采用MED椎间盘镜切除术技术进行髓核摘除及神经根通道清理术.术中通过C型臂X光机引导准确定位,仅做1.6cm纵行切口,沿导针逐级更换套管扩张后放入固定盘手术通道及内窥镜头.于电视监视下显露椎板间隙,咬除少量椎板下缘及黄韧带,扩大椎间隙,显露硬脊膜、神经根及脱出的椎间盘的髓核组织并予以摘除,必要时清理和扩大神经根通道[1].结果:本组治疗腰椎间盘脱出20例,随访3个月～10个月,按Nakai标准评定,优15例,良4例,可1例.结论:经脊柱后路显微内窥镜腰间盘摘除术,技术先进,创伤小,出血少,恢复快,疗效肯定.

ve To investigate the clinical application and indication of spinal microendoscopy for the treatement of lumbosacrai disc herniation(LDH). Method Posterior microendoscopy discectomy (MED) technique was used to remove the nucieus and clean the nerve root canal through an incision of 1.6cm in length under the guidance of the 'C' arm X-ray machine. Results Of 20 patients with LDH undergone MED followed up form 1 to 4 months. 15 were evalualted as excellent 4 as good, and 1 as fair, according to the Macnnab scale. Conclusion Posterior sponal approach Micro Endoscopic Discectomy for the treatment of lumbar disc herniation has characteristics of advanced technique, minimal invasion, fast recovery and thorough decompression to the nerve root. Its effect is postive.