摘要
目的探讨脊柱后路显微内镜(microendoscopic disectomy,MED)手术治疗腰椎间盘突出症合并后纵韧带钙化及椎体后缘骨赘增生的方法. 方法 MED手术中应用自制弧形纤维环刀和L形打入器治疗115例该类患者. 结果全组随访12~30个月,平均22个月,按MacNab标准:优、良109例,可5例,差1例,优良率94.8(109/115).未出现硬脊膜破裂及神经孙上,未发生椎间隙感染,无中转开放手术. 结论正确运用MED技术,配合采用自制器械及相应的改良方法,能较好地处理合并后纵韧带钙化及椎体后缘骨赘增生的难题,进一步扩大了手术适应证范围,提高了疗效及安全性.
Objective To discuss surgical techniques during microendoscopic discectomy (MED) in the treatment of lumbar intervertebral disc herniation complicated with posterior longitudinal ligament calcification and osteophyte of posterior lumbar border. Methods The self-made arc-like annular knife and L-shape introducer were used during MED in the treatment of 115 patients. Results All the patients were followed for 12~30 months (mean, 22 months). According to the MacNab criteria, excellent or good results were achieved in 109 patients, fair results in 5 patients, and poor in 1, the rate of excellent or good results being 94.8% (109/115 ). No ruptured spinal dura mater, nerve root injuries, or infection of intervertebral space occurred. No conversions to open surgery were required. Conclusions Use of self-made instruments and corresponding modified techniques during MED can effectively manage the problems of posterior longitudinal ligament calcification and osteophyte of posterior lumbar border, which broadens the surgical indication and improves the efficacy and safety.
出处
《中国微创外科杂志》
CSCD
2005年第5期369-370,373,共3页
Chinese Journal of Minimally Invasive Surgery
关键词
MED
腰椎间盘突出症
钙化
骨赘
自制器械
MED
Lumbar intervertebral disc herniation
Calcification
Osteophyte
Self-made instrument