| 腰椎后路髓核摘除术微创化过程中的问题与对策 |
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投稿时间：2011-04-17
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| 作者 | Author | 单位 | Address | E-Mail |
| 肖颖 |
XIAO Ying |
桂林医学院附属医院脊柱骨病外科,广西 桂林 541001 |
Department of Spinal Bone Disease Surgery,Affiliated Hospital to Guilin Medical College,Guilin 541001,Guangxi,China |
39668731@qq.com |
| 邹国耀 |
ZOU Guo-yao |
桂林医学院附属医院脊柱骨病外科,广西 桂林 541001 |
Department of Spinal Bone Disease Surgery,Affiliated Hospital to Guilin Medical College,Guilin 541001,Guangxi,China |
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| 唐志宏 |
TANG Zhi-hong |
桂林医学院附属医院脊柱骨病外科,广西 桂林 541001 |
Department of Spinal Bone Disease Surgery,Affiliated Hospital to Guilin Medical College,Guilin 541001,Guangxi,China |
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| 肖荣驰 |
XIAO Rong-chi |
桂林医学院附属医院脊柱骨病外科,广西 桂林 541001 |
Department of Spinal Bone Disease Surgery,Affiliated Hospital to Guilin Medical College,Guilin 541001,Guangxi,China |
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| 严冬雪 |
YAN Dong-xue |
桂林医学院附属医院脊柱骨病外科,广西 桂林 541001 |
Department of Spinal Bone Disease Surgery,Affiliated Hospital to Guilin Medical College,Guilin 541001,Guangxi,China |
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| 张思容 |
ZHANG Si-rong |
桂林医学院附属医院脊柱骨病外科,广西 桂林 541001 |
Department of Spinal Bone Disease Surgery,Affiliated Hospital to Guilin Medical College,Guilin 541001,Guangxi,China |
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| 期刊信息：《中国骨伤》2011年，第24卷，第10期，第831-833页 |
| DOI：10.3969/j.issn.1003-0034.2011.10.009 |
| 基金项目: |
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中文摘要:
目的: 分析腰椎间盘突出症后路开窗髓核摘除术切口微创化过程中常见问题及探讨对策。
方法: 回顾性分析2005年1月至2010年6月采用小切口后路开窗髓核摘除术治疗的497例腰椎间盘突出症患者的临床资料,男395例,女102例;年龄20～78岁,平均43.7岁;单间隙405例,双间隙86例,三间隙6例。分析手术相关并发症并探讨对策。
结果: 手术时间 45～210 min,平均70 min,术后住院时间5～20 d,平均10 d.出现手术相关问题者47例,其中节段定位错误16例(术中发现14例、术后发现2例),神经症状缓解欠佳或加重15例(欠佳12例、加重3例),尿潴留10例,脑脊液漏5例,感染1例。
结论: 腰椎间盘突出症后路开窗髓核摘除术在微创化改良过程中可能出现很多问题,努力提高病变间隙定位能力、正确把握手术适应证及熟练掌握手术操作技巧有利于提高手术疗效和减少并发症。 |
| 【关键词】椎间盘移位 椎间盘切除术 外科手术,微创性 并发症 |
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| Problems and solutions in minimally invasive process of posterior discectomy for lumbar disc herniation |
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ABSTRACT
Objective: To analyze the problems and complications of posterior discectomy for lumbar disc herniation.
Methods: From January 2005 to June 2010,497 patients with lumbar disc herniation were treated by posterior discectomy,which data were analyzed retrospectively.There were 395 males and 102 females,ranging in age from 20 to 78 years with an average of 43.7 years.Among them,405 cases were in single gap,86 cases were in double gaps and 6 cases were in three gaps.The complication of operation and solution was analyzed.
Results: The mean operative time was 70 min (from 45 to 210 min),and the mean hospitalization was 10 d (from 5 to 20 d).Forty-seven cases suffered operative complications.There were 16 cases of wrong location of segments(14 cases occurred in operation and 2 occurred after operation),15 cases of less alleviation or aggravation of nerve symptoms(12 cases were poor alleviation and 3 cases were aggravation),10 cases of urinary retention,5 cases of cerebrospinal fluid leakage and 1 case of infection.
Conclusion: Minimally invasive process of posterior discectomy in treating lumbar disc herniation may complicate with many problems.The operative effects can be improved and the complication can be decreased if the ability of location is improved,surgical indications is correct and the operation is exactly performed. |
| KEY WORDS Intervertebral disk displacement Diskectomy Surgical procedure,minimally invasive Complications |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 肖颖,邹国耀,唐志宏,肖荣驰,严冬雪,张思容.腰椎后路髓核摘除术微创化过程中的问题与对策[J].中国骨伤,2011,24(10):831~833 |
| 英文格式: | XIAO Ying,ZOU Guo-yao,TANG Zhi-hong,XIAO Rong-chi,YAN Dong-xue,ZHANG Si-rong.Problems and solutions in minimally invasive process of posterior discectomy for lumbar disc herniation[J].zhongguo gu shang / China J Orthop Trauma ,2011,24(10):831~833 |
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