经后路全内镜技术治疗腰椎间盘突出症86例疗效观察  

The technical interpretation and clinical curative effectiveness through the full-endoscopic technique in the treatment of lumbar disc herniation

作　　者：孔维军[1] 覃建朴[1] 曹广如[1] 敖俊[1] 蔡玉强[1] 廖文波[1] 

机构地区：[1]遵义医学院附属医院脊柱外科,贵州遵义563099

出　　处：《遵义医学院学报》2015年第3期299-303,共5页Journal of Zunyi Medical University

摘　　要：目的探讨后路全内镜（Full Endoscopic,FE）技术取除突出髓核组织治疗腰椎间盘突出症的可行性及有效性。方法 2012年8月至2013年8月共收治经临床确诊为单节段腰椎间盘突出症患者86例,腰4/5节段35例、腰5骶1节段51例。采用后路全内镜技术取出突出髓核组织的治疗方法,根据术后腰痛及腿痛缓解情况、下床活动及住院时间评估恢复效果。手术前后采用VAS评分评价患者腰痛缓解情况,ODI评分评价患者腿痛及日常工作与生活情况。结果 84例患者顺利完成手术,术后下床时间8~12h,平均10 h;术后住院时间为2~4 d,平均3 d;术后2周恢复非体力劳动的工作。84例患者均无神经根、硬膜损伤及其它手术并发症发生,均获随访,随访时间6~12个月。与术前相比,术后VAS评分及ODI评分明显改善（P〈0.05）。另2例患者改开放手术。结论采取后路全内镜下技术取出突出髓核组织治疗腰椎间盘突出症具有创伤小、神经根减压充分、出血少,恢复快等优点,体现了外科微创手术有的放矢、立竿见影的确切效果。Objective To explore the feasibility and effectiveness through the posterior full-endoscopic（Full Endoscopic,FE） surgery to move the highlighted nucleus pulposus in the treatment of lumbar disc herniation.Methods Between August 2012 to August 2013 86 cases of patients with single segmental lumbar intervertebral disc protrusion were analyzed,including L4 /5 section 35 cases,and L5S1 section 51 cases.Using the posterior endoscopic technique to take out the highlighted nucleus pulposus,postoperative back pain and leg pain relief,ambulation and hospitalization time to assess recovery effectiveness.before and after surgery patients with low back pain VAS score evaluation were adopted to alleviate the situation,ODI score evaluation of patients with leg pain and daily work and life situation was performed.Results 84 patients were successfully completed surgery.Postoperative bed time was 8 ~ 12 h,averaged was 10 h;Postoperative hospital stay for 2 - 4 d,averaged was 3d;After two weeks to recovered non-manual work;84 patients had no nerve root and dural injury and other complications occurred,have been followed up for 6 - 12 months.Compared with the preoperative,VAS scores and ODI scores significantly improved after surgery（P 〈0.05）.the other 2 cases turned to open surgery.Conclusion posterior full-endoscopic（FE） is effective to remove highlighted nucleus in the treatment of lumbar intervertebral nucleus pulposus with small trauma,nerve root decompression fully,less bleeding,and faster recovery.It is a targeted,minimally invasive surgical procedure with immediate effectiveness.

关 键 词：椎板间 全内镜 靶向 腰椎间盘突出症 

分 类 号：R681.5[医药卫生—骨科学]