经横突间入路显微内窥镜下髓核摘除术治疗极外侧型腰椎间盘突出症  

Intertransverse approach microendoscopic discectomy for far lateral lumbar disc herniation

作　　者：李树文[1] 银和平[1] 曹振华[1] 白明[1] 杜志才[1] 王宇鹏[1] 

机构地区：[1]内蒙古医科大学第二附属医院,内蒙古呼和浩特010030

出　　处：《中国骨伤》2014年第9期752-755,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的：探讨经横突间入路显微内窥镜下髓核摘除（MED）治疗极外侧型腰椎间盘突出症的临床效果。方法：对2005年2月至2010年2月经横突间入路显微内窥镜下髓核摘除治疗的极外侧型腰椎间盘突出症73例患者进行回顾性分析,其中男41例,女32例;年龄19-80岁,平均56.5岁;病程1-25个月,平均4.5个月。突出间隙：L3,49例,L4,549例,L5S115例。记录术前、术后2周及末次随访时疼痛强度视觉模拟评分（visual analogue scale,VAS）,评估患者疼痛缓解情况。采用Oswestry功能障碍指数（Oswestry Disability Index,ODI）评价患者术前和末次随访时躯体功能、行走能力等总体生活质量。结果：所有患者手术顺利完成,手术时间40-115 min,平均50 min;出血量50-150 ml,平均110 ml;切口感染1例,神经根不完全损伤1例。73例均获随访,时间3-8年,平均4.5年。术后VAS及ODI分值均较术前有明显改善（P〈0.01）。结论：经横突间入路显微内窥镜下髓核摘除术是治疗极外侧型腰椎间盘突出症有效可行的方法。Objective：To explore the clinical effect of intertransverse approach microendoscopic discectomy for far lateral lumbar disc herniation. Methods：From February 2005 to February 2010,73 patients with far lateral lumbar disc herniation were treated with intertransverse approach microendoscopic discectomy. Their clinical data were retrospectively analyzed. There were 41 males and 32 females,aged from 19 to 80 years old with an average of 56.5 years;courses of disease ranged from 1 to 25 months with an average of 4.5 months. The main symptom was low back pain and sciatica ,especially the sciatica was seriously. Herniation level was in L3,4 of 9 cases,L4,5 of 49 cases,L5S1 of 15 cases. Preoperative,2 weeks after operation,final follow up,conditions of pain relief were assessed by visual analogue scale （VAS）;total life quality of patients were evaluated by Oswestry Disability Index （ODI） before operation and last follow up. Results：All operations were performed successfully, operative time was from 40 to 115 min （mean of 50 min）;and blood loss was from 50 to 150 ml （mean of 110 ml）. Incision infection had 1 case and incomplete nerve root injury had 1 case. All patients were followed up from 3 to 8 years with an average of 4.5 years. Postoperative VAS and ODI had obviously improved （P〈0.01）. Conclusion：The technique of intertransverse approach microendoscopic discectomy is a feasible and effective method for far lateral lumbar disc herniation.

关 键 词：椎间盘移位 椎间盘切除术 内窥镜检查 

分 类 号：R681.53[医药卫生—骨科学]