显微内镜腰椎间盘切除术的常见问题及其处理

目的 评价腰椎后路椎间盘镜手术治疗腰椎间盘突出症的效果,并对MED术中常见问题的处理进行探讨.方法 1999年9月～2004年6月利用后路腰椎间盘镜技术治疗腰椎间盘突出症354例.结果 285例病人获得随访,时间9～54个月,平均27.2个月.该组优205例（71.9%）,良73例（25.6%）,优良率97.5%.无被迫改开放式手术.发生椎间隙感染1例.该组无1例患者术中死亡或发生神经器质性损伤.结论 腰椎后路椎间盘镜手术是治疗腰椎间盘突出症的一种重要而有效的方法.严格掌握手术适应证、熟练的操作技术是提高临床疗效的关键.

Surgical treatment of lumbar intervertebral disc herniation by microendoscopic discectomy through posterior approach:problems and solutions

Objective] To evaluate the surgical results of lumbar intervertebral disc herniation treated by microendoscopic discectomy through posterior approach and to solve the often encountered during surgery.Methods] From September 1999 to June 2004,354 cases with lumbar intervertebral disc herniation were selected for MED.Results] 285 cases were reviewed after surgery.The postoperative follow-up ranged from 9 months to 54 months.The results showed excellent in 205,good in 73,so the rate of excellent and good was 97.5%.No cases converted to open operation and no one died,and no nerve injury occurred during operation.In complications,one case suffered from intervertebral infection.Conclusions] Microendoscopic discectomy through posterior approach is a very important and effective treatment for patients with lumbar intervertebral disc herniation.Appropriate control of indications and skillful surgical technique are the key points to improve the curative effect.