应用X－tube微创治疗腰椎间盘突出症并发症的报道

Application of X-tube in treatment for postoperative complications of lumbar disc herniation

目的：探讨经扩张通道管系统（ METRxX－Tube ）治疗椎间盘突出症（ Lumbar Disc Herniation ， LDH）术的相关并发症，寻找相应原因及预防措施。方法：回顾性分析2012年6月～2014年6月，我院收治的单节段LDH行X－Tube手术治疗106例患者，获得如年龄、性别、节段类型及相关手术并发症等信息。结果：术中中转行标准OD操作手术8例，膜囊撕裂造成脑脊液漏3例，术中神经根牵引不当而拉伤（无根袖撕脱）2例，术中椎管内血管出血2例。随访1～3年，失访21例，失访率19．63％。术后1例手术部位感染，术后6周症状缓解98例，有效率91．59％。随访终末期，责任节段椎体不稳5例，椎体部位复发16例。结论：使用X－Tube治疗单节段LDH存在相关并发症风险，术前严格掌握好适应证，术中个体化操作，术后合理的功能康复锻炼等各个层面，降低X－Tube相关并发症发生率。

Objective：To explore the related complications of METRxX -Tube treatment for LDH , to search for the cause and preven-tive measures.Methods：Retrospective analysis of June 2012 to June2014,the single segment of LDH in our hospital , who treatment of 106 patients by X-tube operation , information such as age , gender , section type and related complications were acquired .Rseults：Op-eration in 8 cases of the switch standard od operation;intraoperative dural sac tear causing cerebrospinal fluid leakage in 3 cases;intraop-erative nerve root improper traction and strain （no root sleeve avulsion） in 2 cases;intraoperative spinal vascular hemorrhage in 2 cases. Follow up 1-3 years, 21 cases were lost, the rate of failure was 19.63%.Postoperative infection of 1 cases, the symptoms of 6 weeks af-ter surgery were relieved in 98 cases, the effective rate was 91.59%.At the end of the follow-up, 5 cases were unstable in the segment of the responsibility segment , recurrence of 16 cases.Conclusion： METRxX-Tube treatment of single segment LDH .there were risks associated with complications , preoperative strict control of indications , intraoperative individual operation, the reasonable functional reha-bilitation exercise and so on at every level , could reduce the incidence of X -Tube related complications .