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1、中國骨傷2005年11月第18卷第11期 ChinaJOrthop&Trauma,Nov.2005,Vol.18,No.11·663··臨床研究·椎間盤鏡手術(shù)治療腰椎間盤突出癥周紅羽,黃曹,張連仁(珠海仁和骨傷醫(yī)院,廣東 珠?！?19020) 摘要 目的:評(píng)價(jià)椎間盤鏡手術(shù)治療腰椎間盤突出癥的臨床療效。方法:腰椎間盤突出癥患者15例,男11例,女4例;平均年齡3918歲。在椎間盤鏡下行腰椎間盤髓核切除、椎板減壓及神經(jīng)根管擴(kuò)大術(shù)。術(shù)前在X線機(jī)下,分別于病變節(jié)段上位棘突下緣、上位椎板下緣中點(diǎn)定位,置入內(nèi)窺鏡
2、頭。在椎間盤鏡配套的監(jiān)視器下咬除部分椎板下緣及黃韌帶,擴(kuò)大椎板間隙,清除椎間盤髓核組織,擴(kuò)大神經(jīng)根管。結(jié)果:本組除1例患者因術(shù)中硬膜囊破裂改為開放手術(shù),其余14例平均手術(shù)出血量60ml,平均手術(shù)時(shí)間86min。本組平均隨訪時(shí)間1312個(gè)月,按照Nakai評(píng)級(jí),優(yōu)11例,良3例,可1例。結(jié)論:椎間盤鏡手術(shù)治療腰椎間盤突出癥比常規(guī)手術(shù)方法視野清晰、創(chuàng)傷小、恢復(fù)快,基本保持了脊柱后柱完整。關(guān)鍵詞 內(nèi)窺鏡外科手術(shù); 椎間盤移位; 椎間盤切除術(shù),經(jīng)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 內(nèi)窺鏡手術(shù)使外科手術(shù)在微小創(chuàng)傷內(nèi)精確、高質(zhì)原酶化學(xué)溶核術(shù);均有不同程度的腰痛伴下肢放射量的完成,較傳統(tǒng)的切開手術(shù)有明顯益處。尤其椎間性疼痛、麻木癥狀及神經(jīng)根
