经皮椎间孔镜下治疗腰椎间盘突出症并发症的原因分析及预防策略  

Analysis of the causes and preventive strategies of the complications of lumbar disc herniation treated by percutaneous endoscopic lumbar discectomy

作　　者：罗鹏明[1] 张国华[1] 张军[1] 王建顺[1] 王新虎[1] LUO Peng-ming;ZHANG Guo-hua;ZHANG Jun;WANG Jian-shun;WANG Xin-hu(Department of Spinal Surgery,Baoji Central Hospital,Baoji,Shaanxi 721008,China)

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》2022年第3期370-372,376,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的分析经皮椎间孔镜下治疗腰椎间盘突出症并发症发生的原因和预防策略。方法回顾性分析本科自2017年1月~2019年9月采用经皮椎间孔镜下治疗的腰椎间盘突出症患者185例,总结并发症发生情况及其原因,并提出预防策略。结果185例患者共出现并发症11例,其中神经根损伤2例,硬脊膜撕裂1例,髓核残留1例,术后感觉异常2例,椎管内出血1例,椎间隙感染1例,类脊髓高压综合征1例,椎间盘突出复发2例。结论经皮椎间孔镜下治疗腰椎间盘突出症的并发症发生率低,但手术风险依然存在,术者必须了解和重视。并发症的发生与手术适应证的选择、术者的经验、患者的康复锻炼有关,总体上其是一种安全有效的方法。Objective To analyze the causes and preventive strategies of complications of lumbar disc herniation(LDH)treated by percutaneous endoscopic lumbar discectomy(PELD).Methods A retrospective analysis was conducted in 185 patients with LDH treated by PELD from January 2017 to September 2019.The occurrence and reasons of complications were analyzed,and the preventive strategies were proposed.Results A total of 11 cases of complications occurred in 185 patients,2 cases of neural structures injury,1 case of dural tear,1 case of nucleus pulposus,2 cases of postoperative paresthesia,1 case of intraspinal hemorrhage,and 1 case of intervertebral space infection.One case of spinal hypertension-like syndrome and 2 cases of lumbar herniated disc recurrence were observed.Conclusion The incidence rate of complications of LDH treated by PELD is low,but the surgical risk still exists,and the operator must understand and pay attention to it.The occurrence of complications is related to the choice of surgical indications,the operators’experience,and the patients’rehabilitation exercise.It is generally a safe and effective method.

关 键 词：腰椎间盘突出症 经皮椎间孔镜下椎间盘摘除术 并发症 

分 类 号：R619[医药卫生—外科学]