小切口开窗治疗腰椎间盘突出症临床分析

目的探讨小切口开窗治疗腰椎间突出症的疗效。方法对322例腰椎间盘突出症行小切口手术，采用联合阻滞麻醉，经常规腰椎间盘手术器械去除上位椎板下缘及下关节突内侧，切除黄韧带，开窗至10mm×8mm大小，用神经剥离子或神经拉钩保护或拉开神经根，取出突出间盘组织，摘除髓核组织，同时对其疗效做出评价。结果322例患者随访2—16个月，平均4．5个月。优135例，良169例，可16例，差2例，优良率达94．4％。全部患者无椎间隙感染、脑脊液漏等并发症。手术出血50～150ml，平均65ml；术时间40—90min，平均60min。结论小切口开窗法是治疗腰椎间盘突出症一种有效方法。

Analysis the technique of small incision for treatment of herniation of lumbar intervertebral discs

Objective To study the clinical application of operation with small incision in treatment of herniation of lumbar intervertebral discs. Methods 322 patients with herniation of lumbar intervertebral discs in different intervertebral space were treated by operation with small incision. Under anesthesia, the top edge of lamina and medial facet with yellow ligament of lumbar intervertebral disc were removed by conventional surgical instruments, the small incision was 10 mm× 8 mm in size, with nerve or nerve - stripping protection or opened nerve root, protruded disc tissue and nucleus pulposus were removed, and its therapeutic effect was evaluated. Results All cases were followed up for 2 to 16 months. The outcome was excellent in 135 cases, good in 169, fair in 77 and bad in 2, and the excellent and good rate was 94.4%. Conclusion The procedure of operation with small incision technique is a very promising way for treatment of patients with herniation of lumbar intervertebral discs.