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经横突间入路显微内窥镜下髓核摘除术治疗极外侧型腰椎间盘突出症
Hits: 2437   Download times: 1222   Received:September 03, 2013    
作者Author单位UnitE-Mail
李树文 LI Shu-wen 内蒙古医科大学第二附属医院, 内蒙古 呼和浩特 010030 The Second Affiliated Hospital of Inner Mongolia Medical University, Huhhot 010030, Inner Mongolia, China  
银和平 YIN He-ping 内蒙古医科大学第二附属医院, 内蒙古 呼和浩特 010030 The Second Affiliated Hospital of Inner Mongolia Medical University, Huhhot 010030, Inner Mongolia, China lswlsw1974@163.com 
曹振华 CAO Zhen-hua 内蒙古医科大学第二附属医院, 内蒙古 呼和浩特 010030 The Second Affiliated Hospital of Inner Mongolia Medical University, Huhhot 010030, Inner Mongolia, China  
白明 BAI Ming 内蒙古医科大学第二附属医院, 内蒙古 呼和浩特 010030 The Second Affiliated Hospital of Inner Mongolia Medical University, Huhhot 010030, Inner Mongolia, China  
杜志才 DU Zhi-cai 内蒙古医科大学第二附属医院, 内蒙古 呼和浩特 010030 The Second Affiliated Hospital of Inner Mongolia Medical University, Huhhot 010030, Inner Mongolia, China  
王宇鹏 WANG Yu-peng 内蒙古医科大学第二附属医院, 内蒙古 呼和浩特 010030 The Second Affiliated Hospital of Inner Mongolia Medical University, Huhhot 010030, Inner Mongolia, China  
期刊信息:《中国骨伤》2014年27卷,第9期,第752-755页
DOI:10.3969/j.issn.1003-0034.2014.09.010


目的:探讨经横突间入路显微内窥镜下髓核摘除(MED)治疗极外侧型腰椎间盘突出症的临床效果。

方法:对2005年2月至2010年2月经横突间入路显微内窥镜下髓核摘除治疗的极外侧型腰椎间盘突出症73例患者进行回顾性分析,其中男41例,女32例;年龄19~80岁,平均56.5岁;病程1~25个月,平均4.5个月。突出间隙:L3,4 9例,L4,5 49例,L5S1 15例。记录术前、术后2周及末次随访时疼痛强度视觉模拟评分( visual analogue scale,VAS),评估患者疼痛缓解情况。采用Oswestry功能障碍指数(Oswestry Disability Index,ODI) 评价患者术前和末次随访时躯体功能、行走能力等总体生活质量。

结果:所有患者手术顺利完成,手术时间40~115 min,平均50 min;出血量50~150 ml,平均110 ml;切口感染1例,神经根不完全损伤1例。73例均获随访,时间3~8年,平均4.5年。术后VAS及 ODI分值均较术前有明显改善(P<0.01).

结论:经横突间入路显微内窥镜下髓核摘除术是治疗极外侧型腰椎间盘突出症有效可行的方法。
[关键词]:椎间盘移位  椎间盘切除术  内窥镜检查
 
Intertransverse approach microendoscopic discectomy for far lateral lumbar disc herniation
Abstract:

Objective: To explore the clinical effect of intertransverse approach microendoscopic discectomy for far lateral lumbar disc herniation.

Methods: From February 2005 to February 2010, 73 patients with far lateral lumbar disc herniation were treated with intertransverse approach microendoscopic discectomy. Their clinical data were retrospectively analyzed. There were 41 males and 32 females, aged from 19 to 80 years old with an average of 56.5 years;courses of disease ranged from 1 to 25 months with an average of 4.5 months. The main symptom was low back pain and sciatica, especially the sciatica was seriously. Herniation level was in L3, 4 of 9 cases, L4, 5 of 49 cases, L5S1 of 15 cases. Preoperative, 2 weeks after operation, final follow-up, conditions of pain relief were assessed by visual analogue scale (VAS);total life quality of patients were evaluated by Oswestry Disability Index (ODI) before operation and last follow-up.

Results: All operations were performed successfully, operative time was from 40 to 115 min (mean of 50 min);and blood loss was from 50 to 150 ml (mean of 110 ml). Incision infection had 1 case and incomplete nerve root injury had 1 case. All patients were followed up from 3 to 8 years with an average of 4.5 years. Postoperative VAS and ODI had obviously improved(P<0.01).

Conclusion: The technique of intertransverse approach microendoscopic discectomy is a feasible and effective method for far lateral lumbar disc herniation.
KEYWORDS:Intervertebral disk displacement  Diskectomy  Endoscopy
 
引用本文,请按以下格式著录参考文献:
中文格式:李树文,银和平,曹振华,白明,杜志才,王宇鹏.经横突间入路显微内窥镜下髓核摘除术治疗极外侧型腰椎间盘突出症[J].中国骨伤,2014,27(9):752~755
英文格式:LI Shu-wen,YIN He-ping,CAO Zhen-hua,BAI Ming,DU Zhi-cai,WANG Yu-peng.Intertransverse approach microendoscopic discectomy for far lateral lumbar disc herniation[J].zhongguo gu shang / China J Orthop Trauma ,2014,27(9):752~755
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