摘要
目的探讨超声刀应用于后路脊柱显微内窥镜椎间盘摘除术(MicroendoscopicDiscectomyMED)治疗腰椎间盘突出症中的优势与疗效。方法我院自2005年1月～11月将根据患者症状、体征、体查、CT和或MRI确诊的腰椎间盘突出症患者97例随机分为两组,超声刀+MED组45例,采用超声刀处理椎板下缘等骨性结构;而常规MED手术组52例采用枪钳或电动磨钻处理。结果超声刀+MED组与常规MED组平均手术时间分别为42min和75min,平均术中失血量分别为29ml和61ml,平均术后引流量分别为13ml和29ml,差异均有显著性(<0.05);两组所有病例获得13月(6～17月)随访,按Macnnab标准,优良率分别为95.6%和92.3%,差异无显著性(0.05)。结论超声刀切割骨骼的同时不损伤软组织,且有同步止血功能,操作安全方便,能缩短MED手术时间,不失为脊柱手术一种理想的辅助工具。
Objective To explore the advantages and effects of ultrasonic cutter appllied in the process of treating Lumbar Disc Herniation (LDH) by Microendoscopic Discectomy (MED).Methods Ninety-two cases of LDH were diagnosed by symptoms,signs,physical examination,CT scanning and/or MRI in the period from January to November,2005.All the cases were divided randomly into two groups.Laminas of forty-five cases were cut by Ultrasonic cutter (group one),and laminas of other fifty-two cases were disposed by rongeur and reamer (group two).Results The average time of operation was 42min and 75min respectively in group one and group two,the average volume of intra-operative blood loss was 29ml and 61ml respectively,the average volume of posto-perative drainage was 13ml and 29ml respectively.Compared with group two,the operative time,the volume of intra-operative blood loss and the volume postoperative drainage of group one were lower significantly (P<0.05).All the cases of two groups were followed-up for 13 months (6 ～ 17months).The outcome was assessed by the criteria of Macnnab,95.6% and 92.3% excellent and good results were obtained in two groups respectively,which was not significantly different (P>0.05).Conclusion Ultrasonic cutter is a good auxiliary apparatus for spinal operation.It cuts the bone without bleeding and soft tissue injuries.It can be used in MED as a safe and convenient method.
出处
《生物骨科材料与临床研究》
CAS
2006年第5期16-18,21,共4页
Orthopaedic Biomechanics Materials and Clinical Study
关键词
超声刀
内窥镜
腰椎间盘突出症
手术
Ultrasonic cutter
Microendoscopic Discectomy
Lumbar Disc Herniation
Operation
