显微内镜下髓核摘除术治疗退变性腰椎管狭窄症60例临床分析

目的探讨显微内镜后路椎间盘手术系统(MED)治疗腰椎管狭窄症的临床疗效。方法对60例椎管狭窄症患者施行后路显微内镜椎间盘摘除术(MED),对其临床资料及疗效进行回顾性分析。结果手术时间45￣130min,术中出血量60～350mL。2例因硬脊膜及神经根与周围组织广泛粘连及出血原因中转开放手术。60例均获得随访,时间3～40个月,平均15个月。按照Nakai评价标准:优40例,良13例,差7例,优良率88.2%(53/60)。结论MED创伤小,出血少,恢复快,在椎管充分减压的前提下,能尽可能保持脊柱的稳定性,是治疗腰椎管狭窄症的有效方法。

Microendoscopic discectomy in treatment of lumbar spinal stenosis in 60 cases

[Objective] To investigate the clinical outcome of the posterior approach microendoscopic discectomy (MED) in the treatment of lumbar spinal stenosis. [Methods] Retrospective analysis of the clinical data of 60 casses of lumbar stenosis treated with MED. [Result] The operation time ranged 45~130 min, intraoperative blood loss of 60~350 mL. A conversion to open operation was required in 2 cases because of widespread adhesion of the dura mater and nerve roots and bleeding. All 60 cases were followed 3~40 months (mean 15 months). According to nakai criteria, excellent 40 cases, good 13 cases, poor 7 cases, the rate of excellent and good was 88.2%(53/60). [Conclusion] MED has the advantage of minimal invasion, little blood loss and rapid recovery. It can offer both full decompression to nerve and the stability of spine to the greatest possible advantage, being an effective means in the treatment of lumbar spinal stenosis in elderly patients.