有限切口双侧椎板间开窗髓核摘除治疗中央型腰椎间盘突出症

Bilateral hemilaminotomy and diskectomy for posterior lumbar disk heniation.

目的 探讨治疗中央型腰椎间盘突出症一种手术方法的可行性及临床效果。方法 31例中央型腰椎间盘突出症患者。单纯中央型 2 3例 ,合并腰椎管狭窄 4例 ,侧隐窝狭窄 5例 ,合并终板撕裂 1例。全组病例均手术治疗 ,采用有限切口 ,双侧椎板间开窗 ,经硬膜外入路摘除突出的腰椎间盘髓核。评价其治疗效果并进行 6月至 5年随访。结果 优 1 4例 ,良 1 3例 ,可 3例 ,差 1例 ,总优良率 87 1 % ,手术无定位失误 ,近期无腰椎失稳和腰椎滑脱 ,无医源性腰椎管狭窄。结论 有限切口双侧椎板间开窗行中央型腰椎间盘髓核摘除 ,能较好地保留腰椎管后部结构 ,术后脊柱稳定性影响小 ,避免了术后硬脊膜与神经根粘连受压 ,手术创伤小 ,康复快 ,操作可行。

Objective To study the treatment of posterior lumbar disk herniation.Methods Thirty one patients with posterior lumbar disk hemiation were treated with bilateral bemilaminotomy and diskectomy.All the cases were followed up for six months to five years and evaluated.Results Twenty seven cases(87.1%)had good to excellent results.No case was unstable in lumbar spine.Conclusion Bilateral hemilaminotomy and diskectomy is an effective treatment for posterior lumbar disk herniation.