腰椎间盘镜治疗腰椎间盘突出症初步报告

目的 探讨显微内窥镜椎间盘切除术(MED)治疗腰椎间盘突出症的特点、适应症及并发症。方法 通道经腰棘突旁切口进入，在显微内窥镜下切除腰椎板下缘、黄韧带、关节突内侧。60例腰椎间盘突出症患者采用MED手术治疗，常规手术开窗法80例作对照，并比较两组出血量、手术时间、住院时间及恢复正常生活／工作时间。结果 所有病例均获得2—20个月随访，平均6．5个月按照Nakal分级，MED组优40例、良15例、可2例，优良率91．67％。结论 MED手术具有创伤小、疗效好、恢复快等特点。MED主要适用于单阶段外侧型腰椎间盘突出症，也适用于部分钙化或侧隐窝狭窄的腰椎间盘突出症，不适用于伴腰椎不稳或中央型腰椎管狭窄的腰椎间盘突出症患者。

Operative treatmeat of the lumbar disc herniation with microendoscopic discectomy

Objective:To study the technical details, clinical results and complication of microendoscopic discectomy for the treatment of lumbar disc herniation.Methods:Sixty patients with lumbar disc herniation were treated with microendoscopic discectomy, other 80 patients with lumbar disc herniation treated with conventional operative discetomy were used as control group.The clinical results were evaluated according to Nakal method and the bloodloss,the operation time, the post operative hospital stay time and the time of recovery to ordinary work or life were surveyed.Results: The excellent and good rate was 91.67 % in studied group,and 90 %in control group,there was not significant difference in all patients between two groups.Conclusions:Microendoscopy discectomy via lamina shows less trauma and faster recovery, it is safe and effective in the treatmeat of lumbar disc herniation,the indication of MED were the lumbar intervertebral disc herniation,part of lumbar intervertebral disc herniation with the calcification or the stenosis or lateral recess,it is prohibited to the lumbar intervertebral disc herniation with lumbar vertebral instability of the central lumbar stenosis.