腰椎间孔镜下治疗腰椎问盘突出症近期效果的观察

目的总结在腰椎椎间孔镜下治疗腰椎间盘突出症患者的临床效果，为该技术临床应用提供参考。方法回顾分析2011年12月至2012年12月应用腰椎间孔镜治疗的48例腰椎间盘突出症患者，其中，腰4—5间盘突出32例，腰5-骶1间盘突出14例，2个节段突出者2例，无3个以上节段患者。观察所有患者手术后6个月内的视觉模拟评分（VAS）法评分。结果48例患者手术时间60-180min，平均（107±20）min；术中出血量5-30ml，平均（15±2）ml；术后切口均I期愈合。术前VAS评分平均为（6．40±0．15）分，术后3个月的VAS评分为（2．25±0．23）分，6个月的VAS评分为（2．45±0．19）分。6个月时2．5分以下45例，5．0分以上3例，疼痛VAS评分小于2．5分患者占93．8％。术后1例患者并发椎间盘炎，经抗炎治疗2周后缓解。1例术后疼痛不缓解患者4个月后在外院行开放手术。术后1例患者腰痛加剧，术后6周再次行椎间孔镜下手术，术后疼痛缓解。结论腰椎间孔镜下腰椎间盘摘除手术是一种安全有效的手术方式，该手术切口小、损伤小、出血少、对患者整体影响小、并发症发生率低，短期内患者疼痛缓解效果确切。

Clinical research of lumbar disc healiation through transforaminal endoscopy

Objective To observe the short-term outcome of transforaminal endoscopy spine system （TESSYS） treating lumbar disc herniation. Methods Between December 2011 and December 2012, 48 cases were reviewed. All cases had undergone disc discectomy through transforaminal endoscopic spine system. The patients in L4.5were 32 cases, in L5-S1 were 14 cases, in both L4.5 and L5-S1 were 2 cases. Results Operation time was （107 ± 20）minutes（ range, 60-180 minutes） and blood loss was （15 ± 2）ml （range, 5 to 30 ml）. All cases inci- sion had achieved good healing. VAS scores were （ 2.25 ± 0.23 ） （ after 3 months） and （ 2.45 ± 0.19 ） （ after 6 months） after operation. One case suffered from disc infection and recovered after two weeks. One case had refracto- ry pain after operation and undergone open operation. One case had two TESSYS resection because reliveless of pain. Conclusions TESSYS technique is a safe and effective choice for the lumbar disc herniation patients. Short- term outcome of ooeration is good. Advantage of this oneration is minimal invasive and little bleeding.