Midas Rex高速磨钻在腰椎后路显微内窥镜下手术中的应用  

Application of Midas Rex high speed drill in the posterior microendoscopic surgery

作　　者：孟志斌[1] 付昆[1] 李俊[1] 李洪潮[1] 李德豪[1] 

机构地区：[1]海南医学院附属医院骨科,海南省海口市570102

出　　处：《中国脊柱脊髓杂志》2007年第11期813-817,共5页Chinese Journal of Spine and Spinal Cord

摘　　要：目的:探讨Midas Rex高速磨钻结合后路显微内窥镜在脊柱手术中的应用效果。方法:采用后路显微内窥镜系统并使用Midas Rex高速磨钻对108例腰椎疾病患者进行腰椎手术,其中腰椎间盘突出症82例,采用显微内窥镜下椎板开窗切除突出的椎间盘;腰椎管狭窄症24例,采用显微内窥镜下椎管减压术;腰椎管内肿瘤2例,采用显微内窥镜下椎板开窗肿瘤切除术。用自行设计的评分方法,对患者手术前、后进行临床评分,术后评分改善率=(术后0～3分的患者数-术前0～3分的患者数/术后0～3分的患者数×100%)。结果:术中出现无神经损伤的硬脊膜撕裂1例,神经根袖外膜破裂1例。术中出血平均20ml,术后平均住院6d,术后第1～2天下地活动,2周后恢复日常生活。平均随访9个月,术前临床表现评分0分1例(0.9%)、1～3分8例(7.4%)、4～6分26例(24.1%)、7～9分73例(67.6%),术后评分为0分78例(72.2%)、1～3分27例(25.0%)、4～6分3例(2.7%),术后评分改善率为91.43%。结论:Midas Rex高速磨钻对骨质磨削精确,操作方便,能在清晰的内窥镜视野下完成椎间盘切除、椎管减压或椎管内肿瘤切除,并发症少,临床疗效满意。Objective：To explore the feasibility and clinical effects of Midas Rex high speed drill combined with microendoscopic system in the minimally invasive spinal surgery.Method：High speed drill system （Midas Rex） combined with the microendoscopic system were used in 108 cases available to minimally invasive lumbar spine operation,82 cases of lumbar disc herniations were treated by microendoscopic discectomy,24 cases of spinal canal stenosis were treated by spinal canal decompress under microendoscopic system ,2 cases of tumor in spinal canal were removed by lamina window-open approach.The clinic effects were evaluated by selfdesigned evaluation score system before and after operation,Result：l case of epidural membrane tear and 1 case of nerve root outer membrane tear with no secondary to nerve injury was noted.The average blood lose was 20ml per case and average hospital stay was 6 days.The patients were allow to walk in one or two days and to return to daily normal life in two weeks after operation.All cases were followed up,the average follow up time is 9 months,According to the score system,the clinic symptoms improved from 0 score 1 case （0,9%）,1-3 score 8 cases（7,4%）,4-6 score 26 cases（24,1%）,7-9 score 73 cases（67,6%） before operation to 0 score 78 cases（72.2%）,1-3 score 27 cases （25.0%）,4-6 score 3 cases（2,7%） after operation respectively,The improvement rate is 91.43%（cases in score 0-3 after operation - cases in score 0-3 before operation/cases in score 0-3 after operationxl00%）,Conclusion：Midas Rex high speed drill is an idea minimally invasive spine operative system for its accurate bone cutting,Which allow discectomy for lumbar disc herniation,more complete decompress and intra-vertebra canal tumor removal with less complications and satisfying clinic effects.

关 键 词：显微内窥镜 高速磨钻 腰椎间盘突出症 腰椎管狭窄症 椎管内肿瘤 

分 类 号：R681.5[医药卫生—骨科学] R687.1[医药卫生—外科学]