改良脊柱显微内窥镜系统手术治疗腰椎管狭窄症的前瞻性研究  

A prospective study of improved system of microendoscopic discectomy for lumbar stenosis

作　　者：陆晓生[1] 赵劲民[2] 彭昊[3] 凌尚准[1] 韦文[1] 

机构地区：[1]广西百色市人民医院骨科,533000 [2]广西医科大学第一附属医院创伤手外科 [3]武汉大学人民医院骨科

出　　处：《中国骨与关节损伤杂志》2013年第5期412-414,共3页Chinese Journal of Bone and Joint Injury

基　　金：广西壮族自治区卫生厅自筹经费计划课题(2010-11-Z2010489)

摘　　要：目的对比研究经改良的显微内窥镜系统(MED)与开放手术治疗腰椎管狭窄症的临床效果。方法对腰椎管狭窄症300例随机采用改良MED(A组)与传统开放手术(B组)治疗。比较手术出血等各相关临床指标。结果两组均成功手术。共10例发生硬膜撕裂,经处理后治愈。B组随访4年后发生腰椎不稳4例,经再次手术治愈。两组均未发生神经根损伤、感染等并发症。复查病情无复发。根据中华医学会腰背痛手术评定标准评定疗效,两组优良率比较差异无统计学意义(P>0.05)。结论采用改良MED治疗腰椎管狭窄症可达到开放手术的满意疗效,且发挥了微创的优势。Objective To compare the therapeutic effect between improved system of microendoscopic discectomy （MED） and traditional discectomy for the treatment of lumbar stenosis. Methods All of 300 patients with lumbar stenosis were divided into the improved MED group （group A） and the traditional group （group B） at random. Surgical bleeding and other clinical indicators were compared. Results All cases had been successfully operated. Five cases suffered from endorachis rupture in each of two grous,which healed by corresponding treatment. There were 4 cases suffered from spine instability in group B postoperative 4 years, which were cured by surgery. There was no other complications such as nerve root injury, infection. Reexamination found no relapse. The clinical effect was assessed according to the standard scoring system of Chinese Spinal Association（CSA）. There was no significant differences between two groups（P 〉0.05）. Conclusion The curative effects of both methods are satisfactory, but the improved system of MED can overcome the defect of traditional discectomy, which can be one of the ideal minimal invasion operation.

关 键 词：椎间盘镜 改良 腰椎管狭窄症 微创 

分 类 号：R687.3[医药卫生—骨科学] R681.53[医药卫生—外科学]