摘要
目的 探讨椎间盘镜手术 (MicroendoscopicDisectomy ,MED)治疗腰椎间盘突出症的手术难点及改良方法 ,以更好的发挥该系统的优势 ,进一步扩大手术适应证 ,提高疗效及安全性。方法 针对MED术中出现的问题 ,自制了拉钩式辅助通道及L型打入器等器械 ,对处理突出纤维环、钙化、中央型突出等方法进行了相应的改良 ,使绝大多数适合手术治疗的腰椎间盘突出症患者能在镜下完成手术治疗。结果 本组 1 1 5例患者 ,近期疗效判定参考MacNab标准 ;优良 1 1 2例、可 2例、差 1例 ,未出现硬脊膜破裂、神经损伤及椎间隙感染。结论 运用MED手术系统 ,配合采用拉钩式辅助通道及L型打入器等自制器械及相应方法 ,能进一步扩大手术适应证范围 。
Objective To discuss operative difficulty of MED in treating prolapse of lumbar intervertebral disc and improving the method of operation,in order to better develope the superiority,expand operative indication of MED system and increase its effect and safety. Methods A hook shape assisting passage and L shape hit into instruments were designed to improve method of dealing with protruding fiber ring,calcification and central type protruding on MED. Results According to MacNab standard,the effect of 150 patients with prolapse of lumbar intervertebral disc was evaluted.Of 150 cases 112 were excellent,2 good and 1 bad.No break of spinal cord dura,nerve injury and infection of intervertebral space occurred. Conclusion Using MED system and pull hook shape assisting passage,L type hit into instrument of handmade and corresponding method can expand operative indication and increase curation and safety.
出处
《骨与关节损伤杂志》
2004年第1期15-17,共3页
The Journal of Bone and Joint Injury