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1、中国骨伤2005年11月第18卷第11期 ChinaJOrthop&Trauma,Nov.2005,Vol.18,No.11·663··临床研究·椎间盘镜手术治疗腰椎间盘突出症周红羽,黄曹,张连仁(珠海仁和骨伤医院,广东 珠海 519020) 摘要 目的:评价椎间盘镜手术治疗腰椎间盘突出症的临床疗效。方法:腰椎间盘突出症患者15例,男11例,女4例;平均年龄3918岁。在椎间盘镜下行腰椎间盘髓核切除、椎板减压及神经根管扩大术。术前在X线机下,分别于病变节段上位棘突下缘、上位椎板下缘中点定位,置入内窥镜
2、头。在椎间盘镜配套的监视器下咬除部分椎板下缘及黄韧带,扩大椎板间隙,清除椎间盘髓核组织,扩大神经根管。结果:本组除1例患者因术中硬膜囊破裂改为开放手术,其余14例平均手术出血量60ml,平均手术时间86min。本组平均随访时间1312个月,按照Nakai评级,优11例,良3例,可1例。结论:椎间盘镜手术治疗腰椎间盘突出症比常规手术方法视野清晰、创伤小、恢复快,基本保持了脊柱后柱完整。关键词 内窥镜外科手术; 椎间盘移位; 椎间盘切除术,经皮Microendoscopicdiscectomyintreat
3、mentoflumbarintervertebraldischerniationZHOUHong2yu,HUANGCao,ZHANGLian2ren.RenheOrthopaedicsHospitalofZhuhai,Zhuhai519020,Guangdong,ChinaAbstractObjective:Toevaluatetheclinicaloutcomesofmicroendoscopicdiscectomyfortreatinglumbarintervertebraldischerniati
4、on.Methods:Fifteenpatients(11male,4female;themeanageof3918years)withthelumbarintervertebraldischerniationweretreatedbythediscectomy,vertebrallaminardecompressionandthenerverootcanalenlargementunderthemicroendoscopy.UnderX2ray,midpointoftheinferiorbordero
5、fspinousprocessandvertebrallaminaonsuperiorofthelesionsegmentwerelocalized,andthemicroendoscopywasplaced.Theinferiorborderofvertebrallaminarandligamentumflavumwereremoved.Theinterspaceofvertebrallaminarwereenlarged.Nucleuspulposusofintervertebraldiscwere
6、cleared.Thenerverootcanalwereenlarged.Results:Among15cases,1casewastreatedbytraditionaldiscectomybecauseofduramaterruptured;Theother14casesweretreatedsuccessfullybymicroendoscopictechnique.Theaverageamountofoperativehemorrhagewas60mlandtheaverageoperativ
7、etimewas86minutes.Afteranaveragefollow2upof1312months,accordingtoNakaiscale,theresultwereexcellentin11cases,goodin3cases,fairin1case.Conclusion:Microendoscopicdiscectomyhasvirtuebycleareroperativefield,fewtrauma,andquickrecoverythantraditionaldiscectomya
8、ndiskeepingtheposteriorstructureofthelumbarvertebrae.KeywordsEndoscopicsurgicalprocedures;Intervertebraldiskdisplacement;Diskectomy,procedures 内窥镜手术使外科手术在微小创伤内精确、高质原酶化学溶核术;均有不同程度的腰痛伴下肢放射量的完成,较传统的切开手术有明显益处。尤其椎间性疼痛、麻木症状及神经根
