单纯髓核摘除治疗脱垂移位型腰椎间盘突出症  

Simple nucleus pulposus removal for the treatment of prolapsed and displaced lumbar disc herniation

作　　者：严红勇 张忠武 霍森 张长青 胡蕖 高晓萍 YAN Hong-yong;ZHANG Zhong-wu;HUO Sen;ZHANG Chang-qing;HU Qu;GAO Xiao-ping(Jiangxia Hospital of Traditional Chinese Medicine in Wuhan,Jiangxia 430200,Hubei,China)

机构地区：[1]武汉市江夏区中医医院,湖北江夏430200

出　　处：《中国骨伤》2021年第4期347-349,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨小切口椎板间开窗单纯髓核摘除术治疗脱垂移位型腰椎间盘突出症的临床疗效。方法:2016年2月至2018年2月,对35例单节段脱垂移位型腰椎间盘突出症患者在全身麻醉下采用小切口椎板间开窗单纯髓核摘除术进行治疗,其中男21例,女14例;年龄(42±17)岁;L_(4,5)节段27例,L5S1节段6例,L_(3,4)节段2例;左侧20例,右侧13例。采用改良Macnab疗效评定标准评价术后症状改善和功能恢复情况。结果:35例患者均顺利完成手术,手术时间30~60 min,平均40 min,手术出血量10~30 ml,平均20 ml。所有患者获得随访,时间1~3年,平均1.2年。35例患者腰痛及下肢症状明显缓解或消失,采用改良Macnab疗效评定标准评定疗效,结果优29例,良5例,可1例。结论:应用微创操作理念,小切口椎板间开窗单纯髓核摘除术治疗脱垂移位型腰椎间盘突出症具有手术时间短,疗效确切,创伤小等优点,在严格掌握适应证的前提下是一种安全有效的手术方法。Objective:To explore the clinical effect of the simple nucleus pulposus removal and small incision interlaminar window in the treatment of prolapsed and displaced lumbar disc herniation.Methods:From February 2016 to February 2018,35 patients with single-segment prolapse and displaced lumbar disc herniation were treated by the simple nucleus pulposus removal and small incision interlaminar window under general anesthesia.Among them,there were 21 males and 14 females;aged(42±17)years;27 cases of L_(4,5)segment,6 cases of L_(5)S_(1)segment,2 cases of L_(3,4)segment;20 cases on the left side,13 cases on the right side.Modified Macnab standard was used to evaluate postoperative symptoms and functional recovery.Results:All the operations were successful and the operation time was 30 to 60 min with an average of 40 min,the intraoperative blood loss was 10 to 30 ml with an average of 20 ml.All the patients were followed up for 1 to 3 years with an average of 1.2 years.Thirty-five patients with low back pain and lower limb symptoms were significantly relieved or disappeared.According to modified Macnab standard,29 cases obtained excellent results,5 good,and 1 fair.Conclusion:Applying the concept of minimally invasive operation,small incision interlaminar window and simple nucleus pulposus removal for the treatment of prolapsed and displaced lumbar disc herniation has the advantages of short operation time,definite curative effect,and less trauma.And it is a safe and effective surgical method under the premise of strict control of the indications.

关 键 词：椎间盘移位 微创外科手术 椎间盘切除 

分 类 号：R681.5[医药卫生—骨科学]