套管翻转滑移在椎间孔镜治疗极外侧型腰椎间盘突出症的运用  

Application effect of turning work casing and sliding technique in treatment of far lateral lumbar disc herniation with percutaneous endoscopic lumbar discectomy

作　　者：刘涛[1,3] 俞兴 卫建民[3] 冯万立[3] 夏斌[3] 刘向伟[3] LIU Tao;YU Xing;WEI Jian-min;FENG Wan-li;XIA Bin;LIU Xiang-wei(Beijing University of Chinese Medicine,Beijing 100700,China;Department of Orthopedics,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;Department of Orthopedics,Baoji City Hospital of Traditional Chinese Medicine,Baoji,Shanxi 721001,China)

机构地区：[1]北京中医药大学,北京100700 [2]北京中医药大学东直门医院骨科,北京100700 [3]宝鸡市中医医院骨科,陕西宝鸡721001

出　　处：《颈腰痛杂志》2023年第4期529-532,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨经皮椎间孔镜(percutaneous endoscopic lumbar discectomy,PELD)下套管翻转滑移技术应用于极外侧型腰椎间盘突出症(far lateral lumbar disc herniation,FLLDH)的技术细节及临床疗效。方法2017年1月~2019年12月,共22例FLLDH患者接受PELD手术治疗,术中应用套管翻转滑移技术,记录手术时间及并发症,并评价手术疗效。结果22例患者顺利完成手术,平均手术时间(59.4±10.5)min,平均随访(11±5.6)个月。术后随访各时间点患者腰痛VAS、腿痛VAS评分及ODI指数较术前均明显改善(P<0.05)。末次随访Macnab疗效评定结果:优16例,良4例,可2例,优良率为90.91%。2例患者下地后,出现下肢放射痛,经保守治疗痊愈。结论PELD套管翻转滑移技术治疗FLLDH安全、有效,但术者要掌握工作通道置入及内镜下操作的技巧。Objective To explore the technical notes and clinical outcomes of percutaneous endoscopic lumbar discectomy(PELD)in the treatment of far lateral lumbar disc herniation(FLLDH)by turning the work casingand sliding.Methods A total of 22 patients with FLLDH underwent PELD from January 2017 to December 2019.During the surgery,the technique of turning the work casingand sliding was applied,the surgical time and complications were recorded,and the surgical efficacy was evaluated.Results All operations went smoothly and successfully,the operations were carried out(59.4±10.5)min;the average follow-up time was(11±5.6)months.VAS of the low back and leg pain,and ODI scores were significantly improved compared with those preoperatively(P<0.05).Based on the modified MacNab criteria,the results were excellent in 16 cases,good in 4 cases and fair in 2 cases at the last follow-up,and the excellent and good rate was 90.01%.Two patients suffered leg pain exacerbated after the first out-of-bed activity,which were cured by conservative treatment.Conclusion It is safe and effective to use percutaneous endoscopic lumbar discectomy in the treatment of far lateral lumbar disc herniation by turning the work casingand sliding.However,surgeons should master the skills of working casing placement and endoscopic operation.

关 键 词：经皮椎间孔镜手术 极外侧型腰椎间盘突出症 翻转滑移 微创技术 

分 类 号：R681.5[医药卫生—骨科学] R687.3[医药卫生—外科学]