中后路椎间盘镜手术治疗腰椎间盘突出症的回顾与展望

目的:总结显微内窥镜下椎间盘切除术(MED)治疗腰椎间盘突出症的经验。方法:根据应用MED的时间将89例腰椎间盘突出症的患者分为两组。2000年12月~2002年11月治疗42例为A组,2002年12月~2004年8月治疗47例为B组。比较两组的手术时间、出血量、并发症及临床效果。结果:A组的手术时间、出血量均大于B组(P﹤0.05),而优良率则小于B组(P﹤0.05)。A组病例术中硬膜及神经根损伤3例,B组病例术中无硬膜及神经根损伤,无切口感染及椎间隙感染。结论:熟练的手术操作,合理选择手术适应证,充分发挥MED的优势,是减少并发症,提高手术疗效的关键。

Retrospective review and prospects for treating lumbar disc herniation with medial posterior endoscopic discectomy

Objective To summarize the experience of microendoscopic discectomy (MED). Method 89cases of lumbar disc herniation were divided into two groups according to date using MED.Group A included 42 cases treated form 2000 Dec, to 2002 Dec. group B included 47 cases treated from 2002 Dec. to 2004 Aug. surgery time, amount of bleeding, complication and curative effect were compared. Results The surgery time and amount of bleeding in goup A are longer and more than group B respectively (P<0.05), and excellent rate is less than group B (P<0.05). In group A 3 cases with dura and neural root lesion,In group B, no case with these lesion and there is no incision infection and intervertebral infection. Conclusion To be with skilled operation, reasonable indication select, to make full usage of MED's advantage are the key points to reduce the complication and elevate the curative effect of surgery.