利用转向钳夹系统行经皮腰椎间盘切除术  

Percutaneous lumbar diskectomy using rotating pliers system

作　　者：郭金和[1] 滕皋军[1] 何仕诚[1] 邓钢[1] 朱光宇[1] 方文[1] 卢勤[1] 

机构地区：[1]南京东南大学附属中大医院放射科,210009

出　　处：《介入放射学杂志》2003年第2期118-121,共4页Journal of Interventional Radiology

摘　　要：目的　探索用可转向钳夹系统治疗腰椎间盘突出伴脱垂患者的可行性。方法　体外试验 :用 2只猪 8个腰椎间盘进行器械的切割实验。临床应用 :选择 12例 (L4 510例、L5 S12例 )经CT或MRI检查证实腰椎间盘突出患者 ,突出物较大 ,压迫硬膜囊均在 4 0 %左右并伴不同程度的脱垂 ,患者症状、体证与影像结果相符 ;采用转向钳夹系统进行突出髓核切除术 ;临床疗效评价采用MacNab标准。结果　体外试验及临床应用均获得成功。临床应用结果 :显效 4例 (33.3% )、有效 5例 (41.7% )、无效 3例 (2 5 .0 % ) ;术后CT复查 :显效、有效患者突出的椎间盘组织均有不同程度回纳、突出物CT值较术前明显降低 ,范围在 8～ 30之间 ,平均 18± 5 ,无效者CT复查结果无变化。结论　用可转向钳夹系统治疗腰椎间盘突出伴脱垂患者是有效的、安全的 。Objective To explore the feasibility of using rotating pliers system for treating lumbar disc herniation with concomitant prolapse.Methods Ex vivo incision experiment was performed on 8 lumbar discs of 2 pigs using rotating pliers. Clinical application included 12 patients of lumbar disc herniation shown by CT or MRI. 40% herniations excerted enough pressure on dural sac with concomitant prolapse of different degrees. The symptoms and image findings were concordant. The herniated nucleus pulposus were resected using rotaing pliers system, MacNab standard was applied for the clinical evaluation. Results The ex vivo experiments and clinical application were successful. Clinical application showed CR in 4 patients (33.3%), PR in 5 patients (41.7%) and NR in 3 patients (25.0%). CT demonstrated the herniated disk tissue retraction of different degrees in CR and PR patients, together with decrease in CT attenuation number, ranging from 8 30 HU, 18±5HU in average but no changes in NR patients.Conclusions Percutaneous lumbar diskectomy is safe and effective to treat lumbar disc herniation with concomitant prolapse by using rotating pliers systems and thus extending the PLD application.

关 键 词：转向钳夹系统 经皮腰椎间盘切除术 腰椎间盘突出 腰椎间盘脱垂 体外试验 

分 类 号：R687.3[医药卫生—骨科学]