| 椎间孔镜经椎板间隙入路手术治疗腰椎间盘突出症 |
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投稿时间：2011-08-10
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| 作者 | Author | 单位 | Address | E-Mail |
| 黄曹 |
HUANG Cao |
深圳市第六人民医院脊柱外科,广东 深圳 518052 |
Department of Spinal Surgery,the Sixth People's Hospital of Shenzhen City,Shenzhen 518052,Guangdong,China |
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| 王尔天 |
WANG Er-tian |
深圳市第六人民医院脊柱外科,广东 深圳 518052 |
Department of Spinal Surgery,the Sixth People's Hospital of Shenzhen City,Shenzhen 518052,Guangdong,China |
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| 王敏 |
WANG Min |
深圳市第六人民医院脊柱外科,广东 深圳 518052 |
Department of Spinal Surgery,the Sixth People's Hospital of Shenzhen City,Shenzhen 518052,Guangdong,China |
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| 易伟宏 |
YI Wei-hong |
深圳市第六人民医院脊柱外科,广东 深圳 518052 |
Department of Spinal Surgery,the Sixth People's Hospital of Shenzhen City,Shenzhen 518052,Guangdong,China |
yiwh@sohu.com |
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| 期刊信息：《中国骨伤》2011年，第24卷，第10期，第806-810页 |
| DOI：10.3969/j.issn.1003-0034.2011.10.003 |
| 基金项目: |
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中文摘要:
目的: 评价椎间孔镜经椎板间隙入路髓核摘除术治疗腰椎间盘突出症的短期疗效。
方法: 对2009年4月至2010年4月采取椎间孔镜经椎板间隙入路手术治疗的27例腰椎间盘突出症患者进行回顾性分析。其中男20例,女7例;年龄21～69岁,平均41.8岁;12例采取“由内向外”髓核摘除术,15例采取“由外向内” 髓核摘除术。采用ODI(Oswestry Disability Index)指数以及改良MacNab标准评定临床疗效。
结果: “由外向内”术式中有1例因出血视野不清中止手术、1例转为椎间盘镜下髓核摘除,其余25例均顺利完成手术。其中20例获得随访,平均随访时间为(18.0±2.5)个月。末次随访时ODI为(13.0±20.5)%,与术前的(75.4±7.8)%比较有统计学差异。按照改良MacNab标准：优7例,良9例,可1例,差3例;疗效差的病例中,1例于术后3个月行开窗手术,2例需口服药物治疗。
结论: 椎间孔镜经椎板间隙入路治疗腰椎间盘突出症,突出物较大、将硬膜囊和神经根明显挤向一侧的患者宜采用“由外向内”的方式,如术前经反复保守治疗、突出物相对较小者则宜采用“由内向外”的方式;合理选择均可以达到有效减压,获得满意临床疗效。 |
| 【关键词】腰椎 椎间盘移位 内窥镜检查 外科手术,微创性 |
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| Follow-up of discectomy with transforaminal endoscope through interlaminar approach for lumbar disc herniation |
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ABSTRACT
Objective: To evaluate the outcomes of discectomy with transforaminal endoscope through interlaminar approach in treating lumbar disc herniation.
Methods: From April 2009 to April 2010,the clinical data of 27 patients with lumbar disc herniation were retrospectively analyzed.The patients were treated with discectomy by transforaminal endoscope through interlaminar approach,including 20 males and 7 females,with an average age of 41.8 years,ranging from 21 to 69 year; of them,12 patients with “from inside to outside” approach and 17 patients with “from outside to inside” approach.All the patients were followed up.Clinical effect were evaluated according to Oswestry Disability Index(ODI) and modified MacNab standard.
Results: The operation of one case was stopped because of unobvious visual field of bleeding and the one case was transferred to microendoscopic discectomy.Other operations of 25 cases were successful.Among 27 patients,20 cases were followed up from 12 to 24 months with an average of (18.0±2.5) months.The mean of ODI improved from preoperative (75.4±7.8)% to (13.0±20.5)% at final follow-up (P=0.000).According to modified MacNab standard,7 cases obtained excellent result,9 good,1 fair and 3 poor.Among the poor outcome,one patient accepted the classical discectomy because of recurrent herniation of same level three months later,and the other two need take medicine.
Conclusion: The discectomy with transforaminal endoscope through interlaminar approach for lumbar disc herniation is effective by decompress through from outside to inside access and from inside to outside access,the former is recommended to the dural sac and nerve root compressed to collateral side by huge protrusion and the latter is recommended to relatively smaller protrusion with long time conservative therapy. |
| KEY WORDS Lumbar vertebrae Intervertebral disk displacement Endoscopy Surgical procedures,minimally invasive |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 黄曹,王尔天,王敏,易伟宏.椎间孔镜经椎板间隙入路手术治疗腰椎间盘突出症[J].中国骨伤,2011,24(10):806~810 |
| 英文格式: | HUANG Cao,WANG Er-tian,WANG Min,YI Wei-hong.Follow-up of discectomy with transforaminal endoscope through interlaminar approach for lumbar disc herniation[J].zhongguo gu shang / China J Orthop Trauma ,2011,24(10):806~810 |
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