摘要
目的 探讨脊柱后路显微内窥镜治疗腰椎间盘突出症的临床应用及适应证。方法 采用脊柱后路显微内窥镜椎间盘切除术 (microendoscopydiscectomy ,MED)技术进行髓核摘除及神经根通道清理术。术中通过床过X光机引导准确定位 ,仅做长 1 5cm纵行切口 ,沿导针逐级更换套管 ,扩张后放入金属手术通道及内窥镜镜头 ,于电视临视下显露椎板间隙 ,咬除少量椎板下缘及黄韧带 ,扩大椎间隙 ,显露硬脊膜、神经根以及突出椎间盘的髓核组织并予以摘除 ,必要时清理或扩大神经根通道。结果 本组共治疗腰椎间盘突出症 4 5例 ,优 3 5例 ,良 7例 ,可 3例。结论 本术式在保证神经根充分减压的基础上 ,尽量减小手术创伤 ,保持脊柱后柱完整性 ,不破坏脊柱的生物力学结构 ,减少手术对脊柱稳定性的影响。由于手术视野放大 1 5倍 ,提高了手术完全性及疗效可靠性。本方法适用于单节段腰椎间盘突出症或合并相同节段侧隐窝狭窄患者。
Objective To investigate the chinical application and indication of spinal microendosopy for the treatment of lumbosacral disc hemiation(LDH). Methdos Posterior microendoscopy discecgtomy(MED) technique was used to remove the nucleus and cleatn the nerve root canal through an incision 1.8cm in length under the guidance of the 'C' arm X-ray machine. Results Of 45 patients with Lundergone MED followed up from 6 to 18 months,35 were evaluated as excellent,7 as good and 3 as fair. Conclusion The MED led to less trauma and little induence on the stability to the posterior stucture of the lumbar vertabrae.The procedure was safe and effective in a surgical field of magnifuication of 15 fold.The indications of MED are single LDH or/with narrowed nerve root canal at the same level.
出处
《中国疗养医学》
2000年第1期27-28,共2页
Chinese Journal of Convalescent Medicine
