腰椎间盘突出合并相应节段椎管狭窄症的微创手术治疗研究

Minimally Invasive Surgery for Lumbar Disc Herniation with Corresponding Segmental Spinal Stenosis

目的探讨单节段腰椎间盘突出合并相应节段腰椎椎管狭窄症的最佳微创手术治疗方法。方法选择我院2016年1月～2017年12月收治的单节段腰椎间盘突出合并相应节段腰椎椎管狭窄症60例患者,均采用经后路开窗半椎板部分切除椎管扩大减压+内镜下突出间盘摘除微创手术治疗,观察手术效果及术后并发症。结果手术优良率为85.00%。CT或MRI影像学复查显示突出物消失,CT椎管前后直径≥16 mm,椎管容积扩大,无椎管改变患者,无感染及神经损伤患者。结论经后路开窗半椎板部分切除椎管扩大减压加经内镜突出间盘摘除治疗单节段腰椎间盘突出合并相应节段腰椎椎管狭窄症微创手术临床效果较好,不影响脊柱稳定性、无需内固定、创伤小、并发症少。

Objective To investigate the best minimally invasive surgical treatment for single segment lumbar disc herniation with corresponding segmental lumbar spinal stenosis. Methods 60 patients with lumbar disc herniation and single-segment lumbar disc herniation admitted to our hospital from January 2016 to December 2017 were treated with posterior fenestration and partial laminectomy. Minimally invasive surgery was performed under pressure + endoscopy to observe the surgical results and postoperative complications. Results The excellent and good rate of surgery was 85.00%. CT or MRI imaging review showed that the protrusion disappeared, CT anterior-posterior diameter ≥16 mm, enlarged spinal canal volume, no spinal canal changes, no infection and nerve injury patients. Conclusion The minimally invasive surgery for lumbar spinal canal stenosis with partial posterior fenestration and partial resection of the vertebral canal and the removal of the endoscopic discectomy is effective. Spinal stability, no internal fixation, minimal trauma, and fewer complications.