椎间孔镜治疗有典型根性症状的腰椎手术失败综合征  

Clinical Evaluation of Transforaminal Endoscopic Spine System in the Treatment of Failed Back Surgery Syndrome with Typical Radicular Symptoms

作　　者：张德辉[1] 李运芝[1] 张智慧[1] 黄涛[1] 黄昌林[1] 

机构地区：[1]解放军150中心医院骨科,洛阳471031

出　　处：《中国微创外科杂志》2014年第7期647-649,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的：评价椎间孔镜治疗有典型根性症状的腰椎手术失败综合征（failedbacksurgerysyndrome，FBSS）的临床效果。方法选择2012年11月～2013年6月12例有典型根性症状的FBSS，其中腰椎间盘突出单纯开窗髓核摘除术后复发5例，腰椎管狭窄髓核摘除并神经根管减压术后复发3例，腰椎间盘突出椎间孔镜髓核摘除术后复发4例。均采用椎间孔镜治疗。结果12例术后患肢直腿抬高试验阴性，神经根刺激所致的患肢疼痛症状均明显缓解，患肢疼痛评分依据视觉模拟评分法（visualanaloguescore，VAS），术前8．3±1．9，术后1个月2．6±1．1（t＝16．301，P＝0．000）。结论椎间孔镜是治疗有典型根性症状的FBSS安全和有效的微创手术，合理选择手术适应证和成熟的椎间孔镜手术经验是保证手术成功的关键。Objective To evaluate clinical results of transforaminal endoscopic spine system in the treatment of failed back surgery syndrome （FBSS） with typical radicular symptoms. Methods Twelve patients with typical radicular symptoms of FBSS were treated by transforaminal endoscopic spine system from November 2012 to June 2013.Among the patients , there were 5 cases of relapse of lumbar disc herniation after simple windowing disectomy , 3 cases of relapse of lumbar spinal stenosis after disectomy and nerve radicular decompression procedure , and 4 cases of relapse of lumbar disc herniation after percutaneous transforaminal endoscopic discectomy . Results In all the 12 patients , limb radicular symptoms were relieved postoperatively , with negative straight leg raising test.Limb pain was measured by means of the Visual Analogue Score （VAS）.The mean VAS was significantly decreased from （8.3 ± 1.9） points before the surgery to （2.6 ±1.1） points at one month after the surgery （t =16.301, P=0.000）. Conclusions Transforaminal endoscopic spine system is safe and efficacious in the treatment of FBSS with typical radicular symptoms .Proper selection of patients and skilled performance are the key to a successful operation .

关 键 词：腰椎 内镜 根性症状 腰椎手术失败综合征 

分 类 号：R687.3[医药卫生—骨科学]