经后路椎板间隙途径显微内窥镜手术治疗腰椎间盘突出症的疗效

目的　分析经后路显微内窥镜手术治疗腰椎间盘突出症手术的疗效及并发症,进一步探讨该手术方法的适 应证及并发症的预防。方法　对获得随访的458例患者的疗效进行分析,按Nakai分级,将疗效分为优、良、中、差4级;并 对724例经后路椎板间隙显微内窥镜手术治疗腰椎间盘突出症患者的手术中和手术后并发症进行分析。结果　术后458 例患者获得随访,疗效分级为:优324例(70.7%),良103(22.5%),中26例(5.7%),差5例(1.1%),优良率为93.2%。出 现的主要并发症包括:9例椎间隙定位错误、2例神经根损伤、3例脑脊液漏和3例椎间感染。结论　经后路椎板间隙显微 内窥镜手术治疗腰椎间盘突出症是一种安全有效的方法,严格选择手术适应证、熟练的操作技术是保证手术成功和减少 并发症发生的关键。

Treatment of lumbar disc herniation by microendoscopic discectomy via posterior interlaminar approach

Objective To evaluate the clinical effects of the treatment of lumbar intervertebral disc protrusion by posterior interlaminar microendoscopic discectomy and to investigate the indications of the approach and the means to prevent the complications. Methods Of the 724 patients who were treated by the posterior interlaminar microendoscopic discectomy, 458 patients were followed up for 2 to 6 months. The clinical results were evaluated by Nakai grade. All the complications encountered in the operation were also analyzed. Results Of the 458 patients, excellent result was found in 324, good result in 103, middle-grade result in 26, and bad result in 5 patients, respectively. The rate of excellent and good results was 92.2%. There were 9 patients who underwent a mistaken intervertebral disc operation. Leakage of cerebrospinal fluid occurred in 3 patients. During the period after operation, 3 patients suffered with intervertebral infection and 2 patients developed the symptoms of nerve root damage. Conclusion Microendoscopic discectomy via the posterior interlaminar space is a safe and effective approach to treat lumbar intervertebral disc protrusion. Selecting surgical indications strictly and manipulating skillfully will achieve better clinical results and reduce the incidence of surgical complications.