个体化靶向穿刺技术在椎间孔镜手术中的应用体会  

Application of individual target puncture in percutaneous endoscopic lumbar discectomy

作　　者：王建顺[1] 张军[1] 张国华[1] 刘夏君[1] 杜伟[1] 罗鹏明[1] 王新虎[1] 左春光 

机构地区：[1]宝鸡市中心医院脊柱外科,陕西宝鸡721008

出　　处：《颈腰痛杂志》2016年第2期121-124,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的总结个体化的靶向穿刺技术在经皮内窥镜下椎间盘切除术(percutaneons endoscopic lumbar discectomy,PELD)的应用体会。方法采用经皮椎间孔镜下对65例腰椎间盘突出症患者进行治疗。采用视觉模拟疼痛评分(visual analogue scale,VAS)和改良Mac Nad标准评定手术疗效。结果腰痛及下肢放射痛VAS评分术前为(8.3±1.2)分,术后3 d为(3.5±1.4)分,差异有统计学意义(P<0.01)。改良Mac Nab标准临床效果评定结果优良率为93.8%,无复发病例。结论TESSYS椎间孔镜技术学习曲线陡峭,需要有丰富的腰椎开放手术经验,具备腰椎三维立体空间思维能力,熟悉腰椎内的解剖关系,经过不断地操作实践才能熟练掌握。Objective To summarize individual target puncture technique in the experience of percutaneous endoscopic lumbar discectomy（PELD）. Methods 65 cases with lumbar disc herniation were treated by PELD. The operation outcome was determined by visual analogue scale and modified Mac Nab standard. Results The preoperative VAS score was（8.3 ±1.2）,the postoperative VAS scores were（3.5±1.4） at 3 day. There was significant difference between the preoperative and postoperative VAS scores（P〈0.01）. According to modified MacNab standard,the excellent rate was 93.8%,So far no case of recurrence. Conclusion Percutaneons endoscopic lumbar discectomy learning curve is steep,need to have a Rich of experience in the lumbar traditional open operation,with a three-dimensional space thinking ability,familiar with the anatomy of the lumbar spine,after continuously operating practice to grasp skilled.

关 键 词：腰椎间盘突出症 内窥镜 靶向 椎间盘移位 

分 类 号：R681.53[医药卫生—骨科学]