椎間盤鏡髓核摘除治療腰椎間盤突出症的臨床分析

Clinical analysis of microendoscopic discectomy in the treatment of lumbar disc herniation

目的總結第二代椎間盤鏡手術系統治療腰椎間盤突出症的效果。方法2002年9月~2010年8月採用椎間盤鏡髓核摘除術治理55例,56個間隙腰椎間盤突出症,單間隙突出者54例,雙間隙突出者1例,L4/534例,L5/S122例。結果所有病例隨訪1~48個月,平均24個月,優良率90.9%,優39例;良11例;一般3例;差2例。神經根損傷1例,硬膜損傷1例,術中中轉1例。結論椎間盤鏡髓核摘除術具有創傷小,恢復快的優點。選擇合適的適應症和熟練的操作是手術成功的關鍵。

Objective To introduce and use the second generation micro-endoscopic discectomy(MED)in the treatment of lumbar disc herniation.Methods 55 cases(56discs)of lumbar disc herniation were operated with MED from september,2002 to august,2010.Among them,single disc herniation were in 54 cases,duble disc herniation in one case,L4/5 herniation in 34 discs,L5/S1 herniation in 22 discs.Results All the cases were followed up 1-48 months(average 24months)with the results of excellent in 39 cases,good in 11cases,fair in 3 cases,fail in 2 cases.The rate of excellent and good was 90.9%.Meanwhile,There was one case of nerve root injury,one case of duramater laceration and one case of opening operation.Conclusion The advantages of MED were minimal invasive and rapid recovery.The suitable indication and precise surgical technique might be the key points for this operation.