[1]余铮　 罗新乐　 李振宇　 闫洪印　 颜滨.后路腰椎间盘镜髓核摘除手术操作难点分析[J].中国微创外科杂志,2004,04(4):312-313.
　Yu Zheng,Luo Xinle,Li Zhenyu,et al.Analysis of difficulties during posterior approach lumbar microendoscopic discectomy[J].Chinese Journal of Minimally Invasive Surgery,2004,04(4):312-313.
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后路腰椎间盘镜髓核摘除手术操作难点分析
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
04
期数:
2004年4期
页码:
312-313
栏目:
出版日期:
2004-04-30

文章信息/Info

Title:
Analysis of difficulties during posterior approach lumbar microendoscopic discectomy
作者:
余铮　 罗新乐　 李振宇　 闫洪印　 颜滨
深圳市第二人民医院脊柱外科,深圳,518035
Author(s):
Yu Zheng;  Luo Xinle;  Li Zhenyu;  et al.
Department ofSpinal Surgery,Shenzhen Second People’sHospital,Shenzhen518035,China
关键词:
腰椎间盘镜; 髓核摘除; 难点
Keywords:
Microendoscopy; 　Lumbar discectomy; 　Difficult points
分类号:
R681.5+3
文献标志码:
A
摘要:
目的探讨后路腰椎间盘镜髓核摘除手术操作的难点. 方法回顾分析2002年2月～2003年10月42例45个间隙的腰椎间盘突出行椎间盘镜髓核摘除手术资料. 结果 3例改开放手术,无术中、术后并发症.随访2～22个月,平均8个月,手术优良率95.2%(40/42).手术操作的难点主要有技术和病因两个方面,包括:通道未对准间隙8例,出血多影响操作5例,器械不配套3例,通道定位错误2例,小关节增生2例,神经根水肿、粘连、撕裂、后纵韧带骨化各1例. 结论椎间盘镜治疗腰椎间盘突出症疗效满意,选择合适的病例和仔细的操作对手术的成功有重要意义.
Abstract:
Objective　To investigate the difficulties in posterior approach lumbar microendoscopic discectomy (MED).　Methods 　We retrospectively analyzed records of 42 cases of lumbar disc protrusion (totally 45 interspaces) treated by MED from February 2002 to October 2003.　Results　Conversion to open surgerywas required in 3 cases.No intra- or post- operative complications were seen.Follow -up survey for 2 ~ 22 months (mean,8 months) found the“good”or“excellent”results in 95·2% of the patients (40/42).Surgical difficulties were mainly classified into two aspects: technical and etiological,including 8 cases of failure of collimation between the passage and the interspace,5 cases of excessive bleeding disturbing the operation,3 cases of incomplete surgical apparatus,2 cases of incorrect passage localization,2 cases of hyperplasia in tiny joints,1 case of ossification of the posterior longitudinal ligament,1 case of nerve root edema,1 case of accretion,and 1 case of laceration,respectively.　Conclusions　Treatment of lumbar disc protrusion with MED gives satisfactory efficacy. Proper selection of patients and careful performance during surgery are essential to a successful procedure.

参考文献/References:

［1］Nakano N,Nakano T.Surgical technique of anterior extroperitoneal lumbar disc herniation.Operation,1987,41:1-6.
［2］李明,陈强,何大为,等.显微内镜治疗腰椎间盘突出症.中国微创外科杂志,2002,2:203-204.
［3］郑召民,郭家伟,刘尚礼.椎间盘镜下腰椎间盘切除术疗效及主要并发症的防治.中国微创外科杂志,2003,3:362-363.
［4］左伟,张希彦,蔺攀.后中路椎间盘镜治疗腰椎间盘突出症术后常见并发症.骨与关节损伤杂志,2001,16:163-166.

更新日期/Last Update: 2014-06-09