CT引导的经皮穿刺腰椎间盘摘除术  

Percutaneous CT Guided Lumbar Discectomy

作　　者：刘德隆[1] 田世杰[1] 王进军[1] 苏庆军[1] 杨煦[1] 郭玉珠 曹宝信 

机构地区：[1]首都医科大学附属北京红十字朝阳医院骨科

出　　处：《中华骨科杂志》1999年第2期89-91,共3页Chinese Journal of Orthopaedics

摘　　要：目的探讨ＣＴ引导的经皮穿刺治疗腰椎间盘突出症的临床应用价值。方法在ＣＴ引导下对３２例腰椎间盘突出患者，利用ＣＴ提供的三维图像穿刺定位，并在三维控制下选择最佳穿刺平面和最佳穿刺途径，进行经皮穿刺椎间关节镜腰椎间盘摘除术。其中男１８例，女１４例。年龄１９～５９岁，平均４０．５岁。随访２～８个月，平均６个月。并与“Ｃ”型臂Ｘ线透视引导的手术进行比较。结果切取椎间盘组织量，Ｌ４，５间隙由平均２．３ｇ增加至４．１ｇ，Ｌ５Ｓ１间隙由平均２．１５ｇ增加至３．２５ｇ。手术优良率由８２．２％，提高至９０．６％。结论ＣＴ引导提高了手术准确性，利于最大程度的切取椎间盘组织，降低椎间盘内压力使突出的椎间盘还纳。Objctive To evaluate the clinical significance of percutaneous microscopic discectomyguided by computed tomography. Methods 32 patients were included in this study. There were 18 malesand 14 females. The mean age was 40. 5 years (range, 19-59 yeare) . The duration of follow up ranged 2 to 8months, with an average of 6 months. Position-setting and puncture were introduced under three-dimensionalCT, andcompared with those under C-airm-X-ray, Result The quantity of removed tissue frtim the disc wasincreased from 2.3 g to 4. 1 g at L 4-5 space, and from 2. 15 g to 3. 25 g at L5-S1 space. The excellent andgood rate was 90. 6qc . Conclusion The CT guided percutaneous lumbar discectomy make the puncturemore precise, and the disc tissue could be taken off fully. As a result, entradiscal pressure was reduced andprotrution of the disc was eliminated.

关 键 词：腰椎 椎间盘突出 CT 椎间盘摘除术 

分 类 号：R681.530.5[医药卫生—骨科学]