Destandau可动式椎间盘镜治疗腰椎间盘突出症  

Destandau mobile endoscopic discectomy technique for lumbar disc herniation

作　　者：姚关锋[1] 齐伟力[1] 王新家[1] 王伟东[1] 曾机灿[1] 孔抗美[1] 

机构地区：[1]汕头大学医学院第二附属医院骨科,广东515041

出　　处：《中国骨科临床与基础研究杂志》2012年第4期245-250,共6页Chinese Orthopaedic Journal of Clinical and Basic Research

基　　金：汕头市科技计划项目(E201100393)

摘　　要：目的探讨Destandau可动式椎间盘镜治疗腰椎间盘突出症的技术特点和疗效。方法 2011年2月至2012年3月汕头大学医学院第二附属医院采用Destandau可动式椎间盘镜治疗腰椎间盘突出症42例共46个椎间盘。根据改良Macnab评分标准评定疗效。结果术后随访3～14个月,平均随访8.4个月。切口平均长度2.3 cm(2.0～3.4 cm),单间隙平均手术时间为66 min(42～105 min)、双间隙为124 min(80～145 min),单间隙术中平均出血量为36.8 mL(21～60 mL)、双间隙为102.4 mL(40～120 mL)。定位错误3例,术中C型臂X线机再次定位后纠正;硬膜囊撕裂2例,术后切口浅表感染3例。术后1～3 d下床活动,平均住院时间5.3 d。末次随访时改良Macnab评分:优29例、良10例、可3例,优良率93%(39/42)。结论 Destandau可动式椎间盘镜使椎间盘摘除手术操作更为方便,减压彻底,患者住院时间短,效果优良。Objective To introduce Destandau mobile micro endoscopic discectomy （MED） technique and to evaluate the clinical results for the treatment of lumbar disc herniation. Methods From February 2011 to March 2012, 42 patients with lumbar disc herination were treated by Destandau mobile MED in the Second Affiliated Hospital of Shantou University Medical College, including 46 segments disc herniation. The clinical effects were evaluated with modified Macnab scale. Results The patients were followed up from 3 to 14 months, and the mean time was 8.4 months. The mean length of incision was 2.3 cm （2.0-3.4 cm）; The mean operative time tbr single segment was 66 min （42-105 min） and was 124 min （80-145 min） for two segments respectively; The estimate blood loss for single segment was 21-60 mL, with the average of 36.8 mL, while 40-120 mL with the average of 102.4 mL for two segments. Complications included location errors in 3 cases, which were recognized intraoperatively and immediately corrected, dural tear in 2 cases and superficial incision infections in 3 cases postoperatively. The mean duration of hospital stay was 5.3 d. According to modified Macnab scale, there were excellent in 29 cases, good in 10 cases and fair in 3 cases, with the excellent and good rate was 93% （39/42） at the last follow-up. Conclusion With Destandau mobile endoscopy, MED can be performed more easily, reduce duration of hospital stay and provide good results for patients with lumbar disc herniation by thorough decompression.

关 键 词：腰椎 椎间盘移位 内窥镜检查 外科手术 微创性 

分 类 号：R687.3[医药卫生—骨科学]