椎间盘镜术中肌肉扩张管对椎旁肌损伤的研究  

Study of the paraspinal muscle change in the microendoscopic discectomy

作　　者：杨维权[1] 汤朝晖[1] 孙荣华[1] 植致敏[1] 朱礼传[1] 朱海云[1] 卫杰[1] 刘大雄[1] 

机构地区：[1]解放军第85医院,上海200052

出　　处：《中国矫形外科杂志》2012年第1期21-23,共3页Orthopedic Journal of China

基　　金：南京军区十一五课题(课题编号:06MA01)

摘　　要：[目的]研究椎间盘镜(MED)术中肌肉扩张管对椎旁肌的损伤。[方法]对30例应用MED手术的腰椎间盘突出症患者肌肉扩张管使用前和手术结束时椎旁肌病理检查以及术前、术后椎旁肌肌电图检查和磁共振检查比较。[结果]椎旁肌肌肉病理检查应用扩张管前后光镜检查无明显变化,电镜检查使用扩张管后有轻度肌纤维溶解,线粒体空泡状以及内质网水肿。椎旁肌肌电生理检查使用前后无显著异常。磁共振检查椎旁肌肌肉萎缩和水肿情况无明显变化。[结论]MED术中肌肉扩张管对椎旁肌肉损伤程度较轻,可减少术后腰部酸痛和僵硬,早日恢复工作和生活,MED是治疗腰椎间盘突出症首选的微创手术方式。[ Objective] To study of the paraspinal muscle change in the microendoscopic discectomy （MED） . [ Methods ] The paraspinal muscle in 30 patients with MED were studied by histopathoiogy before or after tube expansion, the patients were examined by EMG and MRI. [ Results ] Paraspinal muscle biopsy before and after application of the expansion tube showed no significant change in light microscopy, in the electron microscopy results showed a mild dilating muscle fiber dissolution, the endoplasmic reticulum vacuolization and edema. Paraspinal muscles electrophysiological examination showed no significant abnormalities before and after using tube expansion. MR1 of paraspinal muscle atrophy and edema did not change. [ Conclusion] The paraspinal muscle change in the microendoscopic discectomy has less injury.

关 键 词：腰椎间盘突出症 椎旁肌 组织病理学 肌电图 磁共振 

分 类 号：R687.3[医药卫生—骨科学]