椎间盘镜治疗极外侧型腰椎间盘突出症

目的探讨椎间盘镜治疗极外侧型腰椎间盘突出症的方法,观察疗效。方法应用椎间盘镜治疗23例极外侧型腰椎间盘突出症,其中椎间孔突出型14例,椎间孔外侧突出型9例,分别经椎板间入路及经小关节外侧入路,完成神经根探查、减压和椎间盘髓核摘除。结果全部病例镜下完成手术,平均手术时间46min,平均术中出血75mL。平均随访时间13个月,远期疗效:优16例,良5例,可2例,优良率91.3%。结论应用椎间盘镜治疗极外侧型腰椎间盘突出症,手术创伤小,神经根减压彻底,术后恢复快,效果优良。

Application of microendoscopic tubular retractor system in the treatment of far lateral lumbar disc herniation

Objective] To discuss the methods and results of the application of microendoscopic tubular retractor system in the treatment of far lateral lumbar disc herniation.Methods] Twenty-three cases of far lateral lumbar disc herniation were operated with microendoscopic tubular retractor system,of which there were Foraminal disc herniation in 14 cases and extra-foraminal disc herniation in 9 cases.The microendoscopic surgery was performed via vertebral lamina gap approach and zygapophyseal approach respectively.Thorough root exploration,direct decompression and removal of disc material were performed by endoscope.Results] All cases were operated with microendoscopic tubular retractor system,the mean operative time was 46 minutes,and average blood loss was 75 ml.All cases were followed up for 13 months with the results of excellent in 16 cases,good in 5 cases,and fair in 2 cases.Excellent and good rate was 91.3%.Conclusions] It is obvious that this technique has many advantages such as minimal invasive,complete decompression of nerve root and rapid recovery.