经皮突出髓核摘除术治疗极外侧型腰椎间盘突出症54例  

Therapeutic Effect of Percutaneous Lumbar Disectomy for Far Lateral Lumbar Disc Herniation in 54 Cases

作　　者：宋超 陈雪松 王世平 李庆芬 陈继雯 文小玲[3] 

机构地区：[1]云南昆钢医院介入放射科,云南安宁650302 [2]云南昆钢医院疼痛科,云南安宁650302 [3]昆明医学院,云南昆明650031

出　　处：《昆明医科大学学报》2012年第4期85-88,92,共5页Journal of Kunming Medical University

基　　金：云南省教育厅科学研究基金资助项目(09Y0182)

摘　　要：目的探讨经皮突出髓核摘除术治疗极外侧型腰椎间盘突出症可行性及临床效果.方法回顾2008年1月至2011年3月极外侧型腰椎间盘突出症54例共54个椎间盘,用改进后的经皮椎间盘切吸术套件行经皮突出髓核摘除术,观察术前和术后3、7 d VAS评分,术后随访6～18月,按改良"Macnab"分级评定疗效,同时记录患者的术中反应、住院时间和术后并发症.结果手术均获成功;术后短期VAS疼痛评分明显低于术前(P<0.05),按照"Macnab"分级评定,优良率87.03%.结论经皮突出髓核摘除术治疗极外侧型腰椎间盘突出症操作简单、术程短、安全、减压充分、疗效肯定,是治疗极外侧型腰椎间盘突出症新的微创介入疗法.Objective To study the feasibility and clinical value of percutaneous lumbar discectomy(PLD)for far lateral lumbar disc herniation(FLLDH).Methods The data of 54 patients with FLLDH were reviewed from January 2008 to March 2011.54 lumbar discs underwent PLD with improved kit for cutting-aspiration of the disc.The pain score of visual analog scale(VAS)was recorded before and after the operation.The patients were followed up for 6～18 months after operation.The curative effect was ranked by improved Macnab criteria.The intraoperative reaction,hospitalization time and postoperative complications were recorded.Results The all operations were successful.The VAS after the operation was obviously less than that of the score before the operation(P<0.05).Ranked by Macnab criteria,37 cases were excellent,10 cases were good,6 cases were feasible and 1 case was ineffective,with the excellent and good rate of 87.03%.Conclusion PLD for FLLDH is simple,short in operation,safe,sufficient in decompression and effective,which is expected to become an important interventional method for FLLDH.

关 键 词：极外侧型 腰椎间盘突出 经皮髓核摘除术 

分 类 号：R684[医药卫生—骨科学]