对后路显微内窥镜下腰椎间盘摘除术的改进

目的介绍改进的后路显微内窥镜下椎间盘摘除术的手术特点并评估其疗效. 方法采用该手术治疗椎间盘突出症356例,其中中央型突出64例,外侧型突出284例,极外侧型突出8例.伴有侧隐窝狭窄者86例.手术经后入路进行,借助显微内窥镜系统和特殊工具,完成椎管开窗、椎间盘摘除等减压步骤. 结果手术均获成功,术中减压彻底,平均手术时间为40 min.术后第1 d即下床活动,3～5 d出院.所有患者症状均得以缓解;手术后最常见的不适为短期下肢麻木. 结论经后入路的显微内窥镜下椎间盘摘除手术具有创伤小、适应证广、手术时间短、术后恢复快和并发症少等优点,适合大部分椎间盘突出症患者.

The Improved Technique of Posterior Microendoscopic Discectomy for Lumbar Disc Herniation

Objective To evaluate the improved technique and clinical results of the posterior microendoscopic discectomy for lumbar disc herniation. Methods The posterior approch were done in 356 paitents, including 64 of central herniation, 284 of lateral herniation and 8 of far lateral herniation. There were 86 patients with stenosis in the lateral recess. The decompression approaches such as opening the spinal cannal and removal of the disc were completed by microendoscope system and special surgical tools. Results All operations succeeded. The decompression was complete. The mean operation time was 40 minutes. The ambulation was on the first day, and discharging time was 3 to 5 days postoperatively. Symptoms were relieved in all patients. The mainly postoperative complain was temporary numbness in lower limbs. Conclusions Posterior microendoscopic discectomy has the advantages of less trauma, wider indications, shorter operative time, rapider reduction, and less complications, which is suitable for most of the patients with disc herniation.