摘要
目的：回顾性分析经皮内窥镜下腰椎间盘切除术（percutaneous endoscopic lumbar discectomy,PELD）治疗腰椎间盘突出症的并发症及其相关因素。方法：自2006年3月～2010年10月共行经皮内窥镜下腰椎间盘切除术治疗162例腰椎间盘突出症患者，男82例，女80例；年龄21～71岁，平均36．5岁。统计术中、术后早期及术后长期并发症的发生情况。结果：162例患者均获得3，60个月的随访，平均随访30个月。本组患者出现手术并发症共12例．发生率为7.2％。术中发生并发症4例，其中节段定位错误1例，术中活动出血1例，硬膜囊损伤1例，钬激光器械金属头部断裂1例；术后早期发生并发症5例，其中髓核遗漏2例，椎间隙感染1例，神经感觉异常2例：术后中长期并发症3例，2例为同节段椎间盘突出复发，术后遗留活动后明显慢性腰部疼痛1例。结论：经皮内窥镜下腰椎间盘切除术治疗腰椎间盘突出症有一定的并发症，术者的手术经验及技巧、术前准备与术后处理、手术适应证的选择与手术并发症有关。
Objectives： To analyze the complications and reasons of percutaneous endscopic lumbar discectomy （PELD） for lumbar disc herniation（LDH）. Methods： From March 2006 to October 2010, a total of 162 patients underwent PELD for LDH in our hospital. There were 82 males and 80 females, with a mean age of 36.5 years （range 21-71 years）. The complications in intraoperative period and at early or long-middle term in post-operative period were observed. Results： The mean follow-up period was 30 months （range 3-60 months）. The total incidence rate of operative complications was 7.2%. There were 4 patients with intraopera- tive complications： Wrong localization was in 1 patient, Bleeding was in 1 patient, Dural tear was in 1 patient, the head of small laser equipment was broken in 1 patient. There were 5 patients with early postoperative complications, including 1 patient with infection of intervertebral disc and 2 patients had nerve root paraesthesia, 2 patients with nucleus remain. There were 3 patients with medium-term complications after surgery including 2 patients had recurrent herniations at same level, 1 patient had chronic mobile back pain after surgery. Conclusions： Preoperative proper technical considerations, intraoperative skillful manipulation and the strict selection of the indication are the key point to decrease and prevent operative related complication of PELD.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
北大核心
2012年第4期297-301,共5页
Chinese Journal of Spine and Spinal Cord
