经皮穿刺腰椎间盘切割术治疗L_5S_1椎间盘突出症

Percutaneous Diskectomy at the L5 S1 Level

目的：介绍我院所用直套管、非髂骨钻孔法行Ｌ５Ｓ１椎间盘切割术治疗腰椎间盘突出症的经验。材料和方法：本组４３例，男３０例，女１３例，年龄为２２～６１岁。介绍该方法的操作要点及分析影响Ｌ５Ｓ１椎间盘穿刺成功的因素。结果：本组穿刺成功率为９７．６％，有效率为８５．７％。无明显并发症。术后ＣＴ图像上的椎间盘改变与临床症状、体征的改善不成比例。分年龄组的随访中，≥５０岁年龄组患者的有效率较低，仅为３３．３％。结论：经皮穿刺Ｌ５Ｓ１椎间盘切割术是一种安全、简便、有效的治疗Ｌ５Ｓ１椎间盘突出症的方法，值得推广应用。

Purpose: Recommanding the use of the straight coaxial cannula in percutaneous L5 S1 diskectomy without iliac penetration. Materials and Methods: 43 cases underwent percutaneous L5S1 diskectomy, including 30 of male, 13 female and age ranging from 22-61 years old. The author described the key points of procedure and analysed difficulties to approach the L5S1 disc space.Results: In this group of patients the successful rate was 97.6%, the efficient rate 85.7% with no significant complication, changes in the postoperative CT findings were not consistent with the improvement of the signs and symptoms. The efficient rate after follow up showed group >50 years old was very low, 33.3%. Conclusion: Percutaneous diskectomy is a safe, convenient and efficient method for treating herniated L5S1 disc. It's useful for clinical application.