退变性巨大型腰椎间盘突出症的椎间盘镜治疗策略  

Treatment strategy of the great degenerative type lumbar disc herniation by microendoscopic discectomy

作　　者：罗刚[1] 李长青[1] 周跃[1] 

机构地区：[1]第三军医大学新桥医院骨科,重庆400037

出　　处：《中国骨与关节外科》2009年第3期211-214,共4页Chinese Journal of Bone and Joint Surgery

摘　　要：目的通过回顾性研究,探讨腰椎间盘镜下治疗退变性巨大型腰椎间盘突出症的策略和疗效。方法2005年6月至2007年9月,经椎间盘镜下治疗37例退变性巨大型腰椎间盘突出症患者,男29例,女8例;年龄33～65岁,平均43.6岁;L_(3-4)2例,L_(4-5)21例,L_5S_1 14例。患者均有不同程度的腰骶部不适或疼痛,其中17例伴双侧下肢症状,15例伴单侧下肢症状,5例伴大小便功能障碍。术后采用Macnab疗效标准评估手术效果。结果术后随访3～12个月。优良30例,可2例,优良率81.1%。手术切口均一期愈合,无神经根损伤、椎间隙感染及脑脊液漏等并发症。结论运用椎间盘镜工作通道,采用椎板间隙入路通过单侧或双侧椎板开窗术,治疗退变性巨大型腰椎间盘症,既可切除突出椎间盘组织,解除硬膜囊和神经根压迫,又可最大限度保护脊柱的稳定性,取得满意的临床疗效。Objective To summarize and discuss the methods and the effect on the great degenerative type of the intervertebral disc herniation treated by microendoscopic discectomy. Methods： Totally 37 patients （29 males, 8 females） enrolled in our hospital from 2005 to 2007 were analyzed retrospectively, who were diagnosed by great degenerative type lumbar disc herniation and treated by microendoscopic discectomy, L3-4 in 2, L4-5 in 21, L5S1 in 14, course of disease 5 - day to 7 - year. The functional evaluation was performed by Macnab scoring system post - operatively. Results ： Fol- low -up duration was 3 - 12 months; the patients had good or excellent results above 81.1%. Conclusion： It is satisfied that the cases with great degenerative type lumbar disc herniation can be treated by microendoscopic discectomy through the interlaminar

关 键 词：内窥镜 腰椎间盘突出症 微创手术 

分 类 号：R687.3[医药卫生—骨科学]