经皮椎间孔镜下治疗腰椎间盘突出症并发症分析  

Analysis of complications in the treatment of lumbar disc herniation with percutaneous foramen

作　　者：翟凯 李延坤 郭翔 田云虎[2] ZHAI Kai;LI Yankun;GUO Xiang;TIAN Yunhu(Department of Surgery,Weifang Medical University,Weifang 261053,China;Department of Spinal Surgery,the Affiliated Hospital of Weifang Medical University)

机构地区：[1]潍坊医学院外科学教研室,山东潍坊261053 [2]潍坊医学院附属医院脊柱外科

出　　处：《潍坊医学院学报》2020年第2期156-158,共3页Acta Academiae Medicinae Weifang

摘　　要：目的探讨局麻下经皮椎间孔镜下治疗腰椎间盘突出症出现的并发症及预防治疗措施。方法对2018年1月~2019年1月于我院采用经皮椎间孔镜下治疗腰椎间盘突出症的132例患者进行回顾性分析,其中男85例,女47例;平均年龄42.9岁;L3/4突出6例,L4/5突出68例,L5/S1突出58例。统计术中、术后并发症发生率,分析各类并发症发生原因。结果132例患者中,术中发生硬脊膜损伤1例(硬膜与髓核粘连较重),术后未出现脑脊液漏,术后肌力感觉较术前无下降,创口愈合良好;术中术区出血3例,术中使用双极电凝及可吸收明胶海绵后顺利止血;术后髓核残留1例,改用腰椎后路椎板开窗将残留的髓核摘除,疼痛获得缓解;术后复发2例,通过保守治疗及再次行椎间孔镜治疗后症状得到缓解。结论椎间孔镜术前应严格把握手术指征,术中严谨操作,减少术中损伤,术后合理功能锻炼。Objective To explore the complications,preventive measures of lumbar disc herniation under local anesthesia.Methods From January 2018 to January 2019,132 patients with lumbar disc herniation were analyzed retrospectively,including 85 males and 47 females,with an average age of 42.9 years,6 L3,4 protrusions,68 L4,5 protrusions and 58 L5S1 protrusions.The incidence of intraoperative and postoperative complications were analyzed.Results In 132 cases,dural injury occurred in 1 case(the adhesion between dura mater and nucleus pulposus was more serious),no CSF leakage occurred after operation,no decrease of muscle strength after operation compared with that before operation,and the wound healed well;in 3 cases of intraoperative hemorrhage,bipolar electrocoagulation and absorbable gelatin sponge were used during operation to stop bleeding smoothly.One case had residual nucleus pulposus after operation,and the pain was relieved by using posterior laminectomy to remove the residual nucleus pulposus;two cases had recurrence after operation,and the symptoms were relieved by conservative treatment and intervertebral foramen treatment again.Conclusion Before performing intervertebral foramen surgery,we should have strict criteria for the surgical indications,obey the operation rules,reduce the intraoperative damage,and exercise regularly after the operation.

关 键 词：腰椎间盘突出症 经皮椎间孔镜 并发症 

分 类 号：R681.53[医药卫生—骨科学]