微创内镜技术在治疗腰椎间盘突出症中的优势与局限

腰椎间盘突出症(JLDH)是脊柱外科最常见的疾病之一,是导致慢性腰腿痛的常见原因。随着医学科学与技术水平的发展,除了经典的开放式减压手术外,微创技术已成为治疗腰椎间盘突出症的一大重要发展方向。现阶段的临床应用中,微创内镜手术技术用于治疗该疾病主要包括椎间盘镜技术(MED)和经皮椎间孔镜技术(PTED)。与传统开放式手术方式对比,毫无疑问内镜技术的应用具有对组织破坏程度轻、术中出血少以及术后恢复快等一系列明显优势;然而,脊柱内镜技术也有着手术适用范围较传统开放式手术窄,对术者的操作要求也更为严苛等局限性。虽然同为微创内镜技术,MED与PTED技术的原理和适应症亦不相同,本文旨在对两种技术进行详细对比、总结作一综述。

Advantages and limitations of minimally invasive endoscopy in the treatment of lumbar disc herniation

［Abstract］ Lumbar disc herniation（LDH） is one of the most common diseases in spine surgery and also a common cause of chronic lumbago and leg pain. With the development of medical science and technology， minimally invasive technology has become a major development direction for the treatment of lumbar disc herniation besides the classical open decompression surgery. In the current stage of clinical application， minimally invasive endoscopic surgery is mainly used for the treatment of the disease， include microendoscopic discectomy （MED） and percutaneous transforaminal endoscopic discectomy （PTED）. Compared with the traditional open operation， there is no doubt that the application of endoscopy has a series of obvious advantages such as light tissue destruction， less bleeding in the operation， and rapid recovery after operation. However， Spinal endoscopy is also limited， such as narrow scope of application and strict operation. Although minimally invasive endoscopy is the same， the principles and indications of MED and PTED are different. The purpose of this paper is to make a detailed comparison and summary of the two technologies.