可撑开通道系统辅助下显微手术治疗腰椎间盘突出症

目的 探讨Caspar可扩张通道系统辅助下显微手术治疗腰椎间盘突出症的临床效果。方法 选取腰椎间盘突出症30例，在Caspar可撑开通道系统辅助下进行显微手术治疗。术前以及术后1、3、6、12个月，采用疼痛视觉模拟量表（VAS）评分评价疼痛缓解的情况，采用日本骨科协会（JOA）评分评价神经功能改善的情况。末次随访时，采用Macnab分级评价疗效。结果 手术时间为59~78 min，平均（68.50±7.20）min；术中出血量为25~60 ml，平均（32.25±8.6）ml。30例术后复查腰椎MRI均示突出的髓核全部摘除。术中硬脊膜破裂2例，严密修补硬脊膜，术后无脑脊液漏。术后无神经根、马尾神经损伤及椎间隙感染并发症发生。术后1、3、6、12个月VAS评分、JOA评分均明显优于术前（P<0.05）。按Macnab评价标准:优25例，良4例，可1例；优良率为96.7%（29/30）。术后随访1年未见复发。结论 采用Caspar可撑开通道系统辅助，显微手术治疗腰椎间盘突出症疗效确切，术野清晰，神经根减压彻底，对脊柱稳定结构破坏小，是治疗腰椎间盘突出症的一种安全有效的手术方式。

Treatment of lumbar disc herniation with microsurgery assisted by Caspar expandable channel system (report of 30 cases)

Objective To analyze the curative effect of microsurgery assisted by Caspar expandable channel system on lumbar disc herniation. Methods Thirty patients with lumbar intervertebral disc herniation were treated by microsurgery assisted by Caspar expandable channel system. The effects of the operation were assessed by Japanese Orthopaedic Association Scale (JOA) and Visual Analogue Scale (VAS) 1, 3, 6 and 12 months after the surgery and the final results were evaluated by Macnab classification. Results The operations were successfully completed in all the patients. There were no cerebrospinal fistulae after the repair of spinal dura mater which was intraoperatively ruptured in 2 patients. JOA scores were significantly higher 1, 3, 6 and 12 months after the operation (P<0.05), and VAS scores were significantly lower 1, 3, 6 and 12 months after the operation than those before the operation (P<0.05). The excellent and good rate of Macnab functional classification was 96.7% (29/30). Conclusion The microsurgery assisted by Caspar expandable channel system is a safe and effective method to treat lumbar disc herniation and worthy of clinical application and spread.