显微内镜经后路椎板间隙治疗特殊类型腰椎间盘突出症  

Treatment of special types of lumbar intervertebral disc herniation using microendoscopic discectomy system via posterior interlaminal approach

作　　者：初同伟[1] 周跃[1] 王健[1] 张峡[1] 王卫东[1] 李长青[1] 潘勇[1] 

机构地区：[1]第三军医大学附属新桥医院骨科,重庆400037

出　　处：《中国微创外科杂志》2005年第12期1012-1013,共2页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨应用显微内镜椎间盘切除系统(microendoscropic discectomy system,MED)治疗特殊类型腰椎间盘突出症的可行性.方法利用显微内镜椎间盘切除系统(MEDⅡ)对53例多节段(双间隙)腰椎间盘突出症、75例中央型椎间盘突出症和9例极外侧型(椎间孔外型)腰椎间盘突出症进行手术治疗.结果手术均获得成功.手术时间60～110min,平均70 min.术中出血量50～130 ml,平均70 ml.住院时间5～19 d,平均13 d,术后12 d拆线,切口全部Ⅰ期愈合.137例随访3～8个月,平均5个月,无并发症.按Nakai分级标准:多节段腰椎间盘突出症中优40例,良11例,可2例;中央型腰椎间盘突出症中优53例,良17例,可4例,差1例;椎间孔外型中优6例,良2,可1例.结论显微内镜椎间盘切除系统(MEDⅡ)治疗特殊类型腰椎间盘突出症,可取得较好的疗效.Objective To explore the feasibility of the treatment of special types of lumbar disc herniation using microendoscopic discectomy system （MED- Ⅱ ） Methods Posterior interlaminal approach microendoscopic discectomy using the MED - Ⅱ was employed in 53 cases of bi - interspace lumbar disc herniation, 75 cases of central type lumbar disc herniation, and 9 cases of extraforaminal lumbar disc herniation. Results All the operations were successfully completed with an operation time of 60 - 110 min （ mean, 70 min） and an intraoperative blood loss of 50 - 130 ml （ mean, 70 ml）. The length of hospital stay was 5 - 19 days （mean, 13 days）. The stitches were taken out at 12 days after operation and the sutured wound healed by first intention in all the cases. Follow - up for 3 - 8 months （mean, 5 months） showed no complications. According to the Nakai classification, there were 40 cases of excellent results, 11 cases of good results, and 2 cases of fair in the 53 cases of bi - interspace lumbar disc herniation. Of the 75 cases of central lumbar disc herniation, 53, 17, and 4 cases were endowed excellent, good, and fair results, respectively, and 1 ease got a poor result. Of the 9 cases of extraforaminal lumbar disc herniation, the numbers were 6, 2, and 1, respectively. Conclusions Use of the MED - Ⅱ for the treatment of special types of lumbar intervertebral disc herniation is effective.

关 键 词：特殊类型腰椎间盘突出症 显微内镜 腰椎间盘切除术 

分 类 号：R687.3[医药卫生—骨科学]