CT引导下经腹髓核摘除直接减压治疗腰椎间盘突出症的临床应用  

Clinical Application of Transabdominal Lumbar Diskectomy under CT Guidance in the Treatment of Lumbar Disc Herniation through Direct Decompression

作　　者：李晓东[1] 刘士远[2] 薛燕[1] 宿利[1] 

机构地区：[1]山东临沂市人民医院医学影像中心,276003 [2]第二军医大学附属长征医院影像科

出　　处：《中国医学计算机成像杂志》2004年第4期266-269,共4页Chinese Computed Medical Imaging

摘　　要：目的:探讨CT引导下经腹髓核摘除直接减压治疗腰椎间盘突出症的可行性及其适应证。材料和方法:选择62例经CT或MRI检查证实的腰椎间盘突出症病人 ,突出物较大 ,多数病人伴有不同程度的脱垂 ;CT引导下使用自制压腹器压腹定位 ,经皮穿刺病变椎间盘成功后应用扩张套管及钳夹系统摘除髓核 ;临床疗效评价采用Mc Nab标准。结果:62例病人手术3个月以后随访 ,显效50例 ,有效7例 ,无效5例。总有效率91.9 % ,显效率80.6 %。39例 (62.9 % )术中有较大块椎间盘组织取出。结论:CT引导下经腹腰椎间盘髓核摘除术术式 ,提高了直接摘除突出部分髓核组织的成功率 ,在保证安全性及治疗效果的前提下扩展了经皮腰椎间盘摘除术的适应证范围。Purpose:To explore the feasibility of transabdominal lumbar diskectomy under CT guidance in the treatment of lumbar disc herniation through direct decompression and the method's indications.Materials and Methods:Sixty-two cases of lumbar disc herniation shown by CT or MRI were included in this group,featured by bigger herniated disc tissue and with different degrees of concomitant prolapse;Aided by self-made abdomen compressor and localizer and under CT guidance,the herniated disc tissue was removed with cannula and pliers sets after successful herniated disc punctuation.Mac Nab standard was applied to evaluate the clinical efficiency.Results:CR was achieved in50cases(80.6%)3months after the procedure,while PR in7and NR in5cases.The total efficiency was91.9%.Mass tissues of herniˉated disc were pulled out in39cases(62.9%).Conclusions:With the application of transabdominal lumˉbar diskectomy under CT guidance,the rate of success in removing herniated disc tissue was inˉcreased.The scope of PLD indications was extended by the procedure while ensuring safty and satisfied prognosis.

关 键 词：CT引导 治疗 经腹 临床应用 髓核摘除 腰椎间盘突出症 病人 直接 自制 扩展 

分 类 号：R687[医药卫生—骨科学]