经后路椎间盘镜髓核摘除术治疗腰椎间盘突出症

目的 探讨腰椎间盘镜治疗腰椎间盘突出症的进路、疗效及适应症。方法2000年10月-2003年5月采用脊柱后路腰椎间盘镜行髓核摘除术共治疗78例腰椎间盘突出症患者,术中通过“C”型臂X线机引导准确定位,电视监视下咬除少量椎板下缘及黄韧带,保留上下关节突、显露硬膜囊,神经根及突出椎间盘、摘除髓核组织,必要时清理或扩大神经根通道。结果 本组共治疗78例腰椎间盘突出症,随访1月-2年零3月,平均11个月,按Nakai标准评定,优65例,良9例,可4例,无复发,无神经根损伤及硬膜囊撕裂病例。1例并发椎间盘炎。结论 后路椎间盘镜手术在保证神经根通道充分减压的基础上,具有手术创伤轻组织剥离少,保持脊椎中后柱完整性,不破坏脊柱的生物力学结构,出血少,卧床时间短,恢复快等优点。

Microendoscopy disectomy system METRX be used to remove nucleus pulposus for the treatment of interverbral disk herniation

Objective To observe the surgical approach and clinical efficacy and indication of Microendoscopy Discectomy System METRX for treatment of Interverbral disk hemiation. Methods Posterior MED System METRX was used to treat 78 patients under the guidance the "C" arm X - ray machine to remove the nucleus pulposus and relieve the nerve root canal from October 2000 to June 2003. Results Of 78 cases with LDH undergone Microendoscopy Discectomy System METRX followed up from 1 month to 2 years and 3 months with average of 11 months. According to the Nakai scale, of 65 cases had excellent results. 9 had good results and 4 had fair resutls, No patient had nerve root injured and dural teared. One case who developed discits was the only complication. Conclusion Posterior MED technique led to trauma and tissue strip and little influence on the stability of the lumbar vertebrae. The technique can make less blood be lost and the time patient on bed shorten and recovery quickly. The indication of the operation are single side and single vertebralgap, same side and two vertebral space of LDH.