椎间盘镜系统微创治疗臀肌挛缩症

目的探讨利用椎间盘镜技术微创治疗臀肌挛缩症的方法。方法自2002年3月~2004年2月利用椎间盘镜系统治疗臀肌挛缩症21例(共42臀),均有臀部肌肉注射史。在股骨大粗隆上方切开皮肤长1·5cm,置入同轴工作通道,在内窥镜监视下用电凝钩逐束、逐层套钩、汽化切割挛缩纤维带或部分臀肌止点,并动态了解髋关节松解程度,直到满意为止。结果本组21例均获随访,平均随访时间12个月,全部患者“外八字”步态消失,划圈征,蛙腿试验均阴性,本组未发生神经损伤及感染,无术后复发。结论采用椎间盘镜系统及电凝钩治疗臀肌挛缩症创伤小,疗效可靠,安全性高,出血少,可早期功能锻炼,降低了术后再粘连甚至复发的可能性。

Minimally Invasive Microendoscopic Disectomy for Treatment of Gluteal Muscle Contracture Induced by Injection

Objective To explore minimally invasive microendoscopic disectomy for treatment of gluteal muscle contracture induced by injection.Methods From March 2002 to February 2004, twenty-one patients with gluteal muscle contracture (in 42 buttocks) underwent microendoscopic disectomy.All the patients had gluteal muscle injection history.The skin incision of 1.5 cm was made at the top of the greater trochanter.The coaxial working passage was inserted.Under microendoscope,the electrocoagulation hook was used to hook up every sheaf and layer.Vaporization cutting of contracture fibrous band or part gluteal muscle terminal point was performed.The hip joint was released under real time observation until it was satisfied.Results All the patients were followed up for average 12 months.The out -toe gait disappeared in all patients.Snapping hip disappeared.The leg rowing sign,frog leg symptom and the legs crossing test were negative.No nerve injury,no infection and no recurrence occurred after operation.Conclusion The treatment of gluteal muscle contracture with minimally invasive MED is effective,safe and less in blood loss.Early functional exercise can reduce adhesion and recurrence after operation.