椎间盘镜(METRX)髓核摘除术治疗腰椎间盘突出症

目的 探讨METRX腰椎间盘镜治疗腰椎间盘突出症的进路、疗效及适应症。方法 2000年10月至2003年5月采用脊柱后路METRX腰椎间盘镜行髓核摘除术共治疗78例腰椎间盘突出，术中通过“C”型臂X线机引导准确定位，电视监视下咬除少量椎板下缘及黄韧带，保留上下关节突、显露硬膜囊，神经根及突出椎间盘、摘除髓核组织，必要时清理或扩大神经根通道。结果 本组共治疗78例腰椎间盘突出症，随访1个月至2年零3个月，平均11个月，按Nakai标准评定，优65例，良9例，可4例，无复发，无神经根损伤及硬膜囊撕裂病例。1例并发椎间盘炎。结论 后路椎间盘镜手术在保证神经根通道充分减压的基础上，具有手术创伤轻，组织剥离少，保持脊椎中后柱完整性，不破坏脊柱的生物力学结构，出血少，卧床时间短，恢复快等优点。

Removal of nucleus pulposus with microendoscopy disectomy system in the treatment of interverbral disk herniation

Objective To observe the surgical approach and clinical efficacy and indication of microendoscopy discectomy system METRX in the treatment of interverbral disk herniation.Methods Posterior MED system METRX was used to remove the nucleus pulposus in 78 patients under the guidance of the "C" arm X-ray machine and relieve the nerve root canal from October 2000 to June 2003.Results 78 cases with LDH who had undergone Microendoscopy Discectomy System METRX were followed up from 1 month to 2 years and 3 months with an average of 11 months.According to the Nakai scale,65 cases had excellent results,9 had good results and 4 had fairly good resutls.No patient had nerve root injury and dural tears.One case who developed discits was the only complication.Conclusion Posterior MED technique led to trauma and tissue strip and had little influence on the stability of the lumbar vertebrae.The technique can result in less blood losts,short bedridden time and quick recovery.The indications of the operation are single side and single vertebral gap,same side and two vertebral space of LDH.