脊柱内窥镜技术治疗腰椎间盘突出症79例分析  

Micro-endoscopic discectomy for the treatment of 79 cases with lumbar disc herniation

作　　者：许成君 权宗军 许亚琼 王经志 赵文龙 王飞 

机构地区：[1]山东省临沂市第四人民医院疼痛科,山东临沂276005

出　　处：《颈腰痛杂志》2014年第4期282-285,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的：探讨脊柱内窥镜下经椎间孔进入椎管行髓核摘除、神经根松解术治疗腰椎间盘突出症的安全性及有效性。方法79例腰椎间盘突出症患者，经椎间孔逐级磨钻扩张至一区，安放工作套管，在脊柱内窥镜下完成髓核摘除、神经根松解术。采用视觉模拟评分法（VAS）评定，临床疗效用改良的MacNab评价方法评定疗效。结果治疗后1~5天，直腿抬高试验及加强试验与治疗前对比有显著性改善（P﹤0.01）；治疗前后1、3、6个月各时段VAS评分，经比较有显著性改善（P﹤0.01）；治疗后1、3、6个月各时段的临床疗效，显效率1个月94.94%、3个月96.20%、6个月96.20%，显示治疗后总有效率98.73%，有明显的统计学意义（P〈0.05）。结论脊柱内窥镜技术是一种安全、有效、并发症少、适应症广、复发率低的微创治疗腰椎间盘突出症的新方法。Objective To discuss the safety and efficacy of the removal of nucleus pulposus and nerve root brisement to treat lumbar intervertebral disc herniation through intervertebral foramen into canalis vertebralis by spinal endoscope technology. Methods 79 cases with lumbar interverte-bral disc herniation,abrasive drilling expanded to one zone step by step,laid working sleeve,then completed the removal of nucleus pulposus and nerve root brisement technique by spinal endo-scope. The clinical therapeutic results were evaluated by VAS assessment and the improved Mac-Nab curative effect standard. Results After treatment for 1-5 days, straight-leg raising test and intensification test showed significant improvement （P〈0.01）, the hospitalization days were 5-7 days. After 6 months＆#39; follow-up, there was no recurrence. There was significant improvement in VAS score in each period before and after treatment 1,3,6 months after comparison （P〈0.01）. The obvious effective rates after 1,3,6 months＆#39; treatment of each period were 94.94%,96.20%, 96.20%. Total effective rate after treatment was 98.73%,showed obviously statistical significance （P〈0.05）. Conclusion Spinal endoscopic technique was a new method of minimally invasive treat-ment for lumbar intervertebral disc herniation,which was safe,effective,less complications,less indi-cations,low recurrence rate.

关 键 词：腰椎间盘突出症 脊柱内窥镜 椎间孔入路 髓核摘除 神经根松解 

分 类 号：R681.53[医药卫生—骨科学]