后路椎间盘镜在治疗腰椎管狭窄症中的应用

目的：探讨后路椎间盘镜在治疗腰椎管狭窄症中的应用。方法：2000年2月--2001年12月退行性腰椎管狭窄症142例行后路椎间盘镜下椎管有限减压、全椎板或半椎板切除减压、开窗减压术。结果：应用后路椎间盘镜行椎管有限减压87例，减压松解充分。82例随访平均18月，优良率92．7％(优58例，良18例)。无并发症。结论：单纯腰椎间盘膨出或突出、黄韧带肥厚和小关节增生引起的退行性腰椎管狭窄症是后路椎间盘镜下椎管有限减压的适应证。满意的手术效果取决于：病人选择适当，术中操作精细，减压彻底。

Posterior approach microendoscopic surgery in the treatment of lumbar spinal stenosis

Objective To study the clinical application of posterior approach microendoscopy in the treatment of lumbar spinal stenosis. Methods One hundred and forty-two cases of degenerate lumbar spinal stenosis were treated by posterior approach limited decompression, total or semi laminectomy and decompression, or fenestration decompression from February 2000 to December 2001. Results Out of the 142 cases, posterior approach microendoscopic limited decompression was completed in 87 cases with full decompression obtained.Follow-up for a mean of 18 months in 82 cases revealed a rate of excellent-and-good of 92.7% (58 cases, excellent; 18 cases, good).No complications occurred. Conclusions Degenerate lumbar spinal stenosis, resulted from simple lumbar intervertebral disc herniation, hypertrophy of ligamentum flavumcan, and facet hypertrophy, can be effectively treated by posterior approach microendoscopic limited decompression. Proper selection of patients, full decompression and experienced operative skills are the key to satisfactory surgical results.