椎间盘镜与自制微型器械联合应用治疗腰间盘突出症

目的：介绍椎间盘镜与微型器械联合应用治疗复杂性腰椎间盘突出症，方法：40例复杂性腰椎间盘突出症患者，经脊柱后路显微内窥镜下，应用自制微型骨刀或微型环切除增生内聚的小关节突和钙化的椎间盘组织，行侧隐窝及神经根管扩大术。结果：术后随访3－6个月，按Nakai分级标准评定：优34例，良4例，可2例，优良率为95％，结论：改良手术器械的使用，扩大了椎间盘镜的适用范围，创伤小，操作安全。

Application of microendoscopic discectomy in combination with self made miniature instruments for management of lumbar disc herniation

Objective To introduce application of microendoscopic discectomy in combination with self made miniature instruments to treat complex lumbar disc herniation. Methods Using improved operation instrument, 40 cases of complex lumbar disc herniation were treated by posterior interlamina apporach to use self made miniature osteotome or miniature trepan resecting the hyperplastic interior osteophymas of apophysis joints and calcific lumbar disc tissue and lateralrecessus and nerve root canal enlargement operation with microendoscopy. Results The patients were followed up from 3 to 6 months. The results were excellent in 34 cases, good in 4 cases, fair in 2 cases according to the Nakai standard scale. The rate of excellent and good clinical results was 95%. Conclusion Improving operation instrument to extend the extent of the indications of posterior microendoscopy operation that produces minimal invasion, and is a safe procedure.