摘要
目的 总结显微内窥镜腰椎间盘切除(Microendoscopic discectomy MED)治疗腰椎间盘突出症的临床效果。方法 采用椎间盘切除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,在棘突旁0.5～1cm处仅做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、神经根及突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。结果 本组治疗腰椎间盘突出30例,随访1～12个月,按Nakai标准评定,优:25例,良:4例,可:1例。结论 应用经脊椎后路显微内窥镜摘除腰椎间盘,技术先进,创伤小,出血少,恢复快,疗效肯定。
Objective To investigate the clinical application and indication of spinal microendoscopy for the treatement of lumbosacral disc herniation (LDH) .Methods Posterior microendoscopy discectomy(MED) technique was used to remove the nucleus 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 Thirty cases of LDH were treated and followed up for 1 to 12 months. 25 cases were evaluated as excellent,4 as good, and 1 as fair, according to the Nakai scale. Conclusion Posterior spinal approach microendoscopic discectomy is effective for the treatment of lumbar disc herniation with minimal invasion, fast recovery and thorough decompression to the nerve root.
