腰椎间盘突出症的显微内窥镜治疗

TREATMENT OF LUMBOSACRAL DISC HERNIATION BY MICR OENDOSCOPIC DISCECTOMY

目的 :探讨脊柱后显微内窥镜治疗腰椎间盘突出症的临床应用及适应证。方法 :采用脊柱后路显微内窥镜腰椎间盘切除术 (microendoscopydiscectomy ,MED)及神经根通道扩大术。术中通过“C”型臂X线机引导准确定位 ,仅做长 1.8cm纵行切口。结果 :该组共治疗腰椎间盘突出症 2 5例 ,随访 3～ 8个月 ,按Nakai标准评定 :优 2 1例 ,良 3例 ,可 1例。结论 :该术式能保证神经根充分减压 ,减小手术创伤 ,保持脊柱后柱的完整性 ,不破坏脊柱的生物力学结构。由于手术视野放大 64倍 ,提高了手术安全性及疗效可靠性。

Objective:To investigate the clinical applicat io n and indication of spinal microendoscopy for the treatment of lumbar disc herni ation(LDH).Methods:Posterior microendoscopy discectomy(MED)technique was us ed to remove the nucleus and enlarge the nerve root canal through an incision of 1.8cm in length under the guidance of the 'C' arm X-ray machine.Results:Of 25 patients with LDH undergone MED followed up from 3 to 8 months ,21 were evaluated as excellent ,3 as good,1 as fair according to t he Nakai scale.Conclusion:The MED led to less trauma and little influence on the stability of the posterior structure of the lumbar vertebrae.The procedure was safe and effective in a surgical field of magnification of 64 folds .The ind ications of MED are single LDH or/with narrowed nerve root canal at the same lev er.