改良式经皮穿刺腰椎间盘钳取术

目的对经皮腰椎间盘钳夹术(PLD)进行改良以提高疗效和扩大适应证。方法术前设计经皮穿刺腰椎间盘的径路，使其尽可能接近突出块，采用专用髓核钳夹取突出部髓核。655例椎间盘突／脱出症患者共750节椎间盘进行改良PLD术治疗，经随访6～54个月并对随访结果进行统计分析。结果术后疗效优40．2％、良46．6％、差13．3％；无椎间盘感染和腰肌血肿等并发症；合并马尾损伤1例，器械断裂4例。结论改良式钳夹术安全有效，不仅适应于“包容性”椎间盘突出症，而且适应于“非包容性”椎间盘脱出症治疗。

Ameliorative percutaneous lumbar discectomy

Objective To ameliorate the percutaneous lumbar discectomy(APLD)for improving the effectiveness and amplifying the indicative range of PLD.Methods To ameliorate percutaneous punctured route based on classic PLD and discectomy of extracting pulp out of the herniated disc with special pulpforceps. The statistical analysis of the therapeutic results on 750 disc protrusions of 655 cases undergone APLD following up from 6 to 54 months retrospectively. Results The effective ratios were excellent in 40.2%, good for 46.6% and bad of 13.3%. No occurrance of intervertebral inflammation and paradiscal hematoma, there were only 1 case complicated with injuried cauda equina, and 4 cases with broken appliance within disc.Conclusions APLD is effective and safe, not only indicative for inclusion disc herniation,but also for noninclusion herniation.