后路椎间盘镜手术治疗退变性腰椎管狭窄症

目的 探讨后路椎间盘镜系统(microendoscopic discectomy system,MED)在腰椎管狭窄症治疗中的应用.方法 回顾性分析2008年12月至2011年12月我院26例腰椎管狭窄症行手术治疗病例,其中男14例,女12例;年龄55～72岁,平均64岁.患者均在椎间盘镜下行椎管减压术.根据日本矫形外科学会(JOA,29分)评分标准和Nahal分级进行术前和术后的疗效评价.结果 26例患者获得6～48个月随访,平均随访时间22个月.术后6个月JOA评分平均改善率75.17％,按Nahal分级进行疗效评价,其中优16例,良8例,可2例,临床优良率为92.31％.结论 腰椎管狭窄症压迫脊髓出现腰腿痛和神经系统症状,应尽早手术治疗,根据患者病情和影像学表现,明确责任病变椎间隙,采用椎间盘镜下椎管减压术可获得满意的疗效.

Microendoscopic Discectomy for Lumbar Spinal Stenosis

Objective To discuss the application of MicroEndoseopic Discectomy System in the surgical treatment of lumbar spinal stenosis. Methods This study retrospectively reviewed 26 patients with lumbar spinal stenosis from December 2008 to December 2011 ,which were treated operatively. All patients were treated with posterior microendo- scopic discectomy. The results of treatment were evaluated by criteria of Japan Orthopedic Association （JOA, 29） score and Nahal grading. Results 26 cases were followed up for 6~48 months. The average followed up period was 22 months. The mean postoperative improvement rate was 75.17 %. There were excellent in 16 cases ,good in 8 cases, fair in 2 cases, and excellent and good rate was 92. 31~/00. Conclusion Lumbar spinal stenosis lead to compressive myelopathy,which should be treated with decompression of the spinal canal as early as possible. The intervertebral space should be confirmed according to patients＇clinic symptom and radiology evaluation. The clinical effect of mi- croendoscopic disceetomy is satisfactory.