脊柱内窥镜配合气动磨钻行腰椎间盘摘除和侧隐窝扩大术

Lumbar Lateral Recess Enlargement and Discectomy by Micro Endoscopic Discectomy System(MED) with Bone Drill

目的 介绍脊柱内窥镜 (MED)配合气动磨钻行腰椎间盘摘除和侧隐窝扩大术的方法和临床效果。方法 1999年 2月～ 2 0 0 0年 2月间共施行MED手术 188例 ,其中配合气动磨钻行腰椎间盘髓核摘除和侧隐窝扩大术 95例。结果 全部患者术后无严重并发症。平均随访 37个月。按Nakal疗效评定标准 ,优 5 5例、良 31例、可 7例、差 2例 ,优良率为 90 5 %。结论 MED手术具有创伤轻、出血少、恢复快及较为安全等优点 ,配合气动磨钻行腰椎间盘髓核摘除和侧隐窝扩大术疗效确切 。

Objective To describe lumbar lateral recess enlargement and discectomy by microendoscopic discectomy system(MED) with bone drill via posterior approach.Methods From February 1999 to February 2000,188 cases were treated by MED, among which 95(50 5%) received lumbar discectomy and enlargement of the lateral recess.Difficultics and skills of the operative procedures were given a minute description.High speed bone drill(Mednext Drill) was used during operation.Results All patients had no death.Ninety-five cases were given an average of 37 month follow up, and the results showed 55 cases excellent、31 good、7 fair and 2 poor,the rate of excellent and good was 90 5% according to Nakal evaluation standard.Conclusion MED operation has the characteristics of less injury、rapider rehabilitation and thorough decompression to the nerve root. The lumbar disc herniation and lateral recess stenosis may be treated by MED with bone drill.