Joimax椎间孔镜治疗L5/S1椎间盘突出症的手术入路选择

Selection of operation approach of Joimax foraminal mirror treatment of l5/s1 intervertebral disc herniation

目的探讨joimax椎间孔镜经侧路椎间孔及后路椎板间隙两种入路治疗L5/S1椎间盘突出症的方法及疗效。方法收集2010年1月-2013年12月L5/S1椎间盘突出症患者56例,采用joimax椎间孔镜针对不同情况选择侧或后路进行治疗,观察评测术后即刻、1周、3个月、6个月、12个月的VAS、JOA及Oswestry评分。结果 56例患者平均手术时间50 min,出血15 ml,术中无神经根损伤,无中途转换开放式手术,除1例外,余均诉症状完全缓解,MR示减压充分,中央椎管扩大,神经根无受压,椎板关节突、椎旁肌无损伤。随访评测比较手术前后及各期VAS、JOA及Oswestry评分,差异有显著性。结论 Joimax椎间孔镜下椎间盘髓核摘除术有安全、微创、视野明晰、出血少及恢复快等优点,侧路与后路两种入路相互补充,近、远期疗效好。

[ Objective ] To investigate the method and curative effect of the two approaches joimax intervenebral foramen mirror in posterior intervertebral foramen and lateral road gap for the treatment of LS/S1 intervertehral disc herniation. [Methods] 56 cases from 2010 to 2013 with LS/S1 disc herniation intervertebral foramen, the joimax mirror treatment was conducted in the light of the selection of different posterior lateral or evaluation, obser- vation was carried out immediately after operation, 1 week, 3 month, 6 months, 12 months of VAS, JOA and Os- westry score. [Results] Of the 56 patients, the average operation time was 50 min, 15 mL blood, no nerve root in- jury during open operation, without intermediate conversion, except for 1 case of side road operation in patients with complete remission of symptoms, MR showed adequate decompression, central vertebral canal, nerve root without compression, translaminar facet, paravertebral muscle no damage. There were significant differences in follow-up e- valuation after operation and different stages of VAS, JOA and Oswestry scores. [ Conclusion ] The joimax trans- foraminal endoscopic discectomy is safe, minimally invasive, clear vision, the advantages of less bleeding, rapid re- covery, a side road and two posterior approach complement each other, made nearly, long-term good curative effect in clinical practice.