[1]徐　峰　张同会　蔡贤华　杨楚枫　李　涛　徐　斌.经皮内窥镜下椎间盘切除术治疗腰4/5并腰5/骶1椎间盘突出症（附41例报告）[J].中国临床神经外科杂志,2016,(04):206-209.[doi:10.13798/j.issn.1009-153X.2016.04.005]
　XU Feng,ZHANG Tong-hui,CAI Xian-hua,et al.Clinical observation of percutaneous endoscopic lumbar discectomy on L4/5 and L5/S1 lumbar disc herniation (report of 41 cases)[J].,2016,(04):206-209.[doi:10.13798/j.issn.1009-153X.2016.04.005]
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经皮内窥镜下椎间盘切除术治疗腰4/5并腰5/骶1椎间盘突出症（附41例报告）()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2016年04期
页码:
206-209
栏目:
论著
出版日期:
2016-04-25

文章信息/Info

Title:
Clinical observation of percutaneous endoscopic lumbar discectomy on L4/5 and L5/S1 lumbar disc herniation (report of 41 cases)
文章编号:
1009-153X（2016）04-0206-04
作者:
徐　峰　张同会　蔡贤华　杨楚枫　李　涛　徐　斌
430070 武汉，广州军区武汉总医院骨科
Author(s):
XU Feng;  ZHANG Tong-hui;  CAI Xian-hua;  YANG Chu-feng;  LI Tao;  XU Bin.
Department of Orthopaedics, Wuhan General Hospital, Guangzhou Command, PLA, Wuhan 430070, China
关键词:
双节段腰椎间盘突出症; 经皮内窥下镜椎间盘切除术; 椎间孔入路; 疗效
Keywords:
Lumbar disc herniation;  L4/5;  L5/S;  Percutaneous endoscopic lumbar discectomy;  Targeted puncture technique
分类号:
R 681.5+7
DOI:
10.13798/j.issn.1009-153X.2016.04.005
文献标志码:
A
摘要:
目的 探讨经皮内窥下镜椎间盘切除术治疗腰4/5并腰5/骶1椎间盘突出症的疗效及安全性。方法 选择2011年3月至2014年12月收治的41例腰4/5并腰5/骶1椎间盘突出症患者，运用局麻+监护在C臂机透视下分节段行靶向穿刺，经皮内窥镜椎间孔入路下行髓核摘除术。采用视觉模拟量表（VAS）评分和MacNab标准评估手术疗效。结果 41例均顺利完成手术，无术中更改术式，术后无神经根损伤、椎间隙感染等并发症发生。手术时间为72~106 min，平均（85±12.4） min。术中出血量为（30±5） ml。41例术后随访18~24个月，平均20.5个月；术后腰痛和腿痛VAS评分均明显下降（P<0.05），而且随随访时间延长，vas评分下降越明显（>P<0.05）。按macnab标准评定疗效优良率95. 1%。本组41例均无复发。结论 经皮内窥下镜椎间盘切除术治疗腰4/5并腰5/骶1椎间盘突出症具有切口小、创伤小、并发症少、对脊柱稳定性影响小、术后恢复快、近期疗效可靠等优点。
Abstract:
Objective To discuss the curative effect of percutaneous endoscopic lumbar discectomy on the lumbar disc herniations of L4/5 and L5/S1 double segments and its safety. Methods Forty-one patients with L4/5 and L5/S1 double segment lumbar disc herniations were treated by percutaneous endoscopic lumbar discectomy in our hospital from March, 2011 to December, 2014. Under local anesthesia the target lumbar discs were positioned and gelatinous nuclei were removed through percutaneous endoscopic lumbar discectomy with the help of the C-arm fluoroscopy. The surgical effects were assessed by a visual analog scale (VAS) and MacNab criteria. Results The average operative duration were (85±12.4) minutes and an average blood loss was (30±5) ml during the operation. Forty-one patients were followed up from 18 to 24 months (mean, 20.5 months). VAS scores were significantly higher before and 1 day after the operation than those 3 months after the surgery (P<0.05), which="" were="" significantly="" higher="" than="" those="" 6="" and="" 12="" months="" after="" the="" surgery="" (P<0.05). the="" excellent="" and="" good="" rate="" of="" curative="" effect="" was="" 95.1%="" according="" to="" macnab="" criteria.="">Conclusions The treatment of lumbar disc herniation of L4/5 and L5/S1 double segment through percutaneous endoscopic lumbar discectomy has the advantages such as small incision, less trauma, fewer complications, a small effect on the stability of the spine, rapid postoperative recovery and a reliable short-term effect.

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备注/Memo

备注/Memo:
基金项目：湖北省自然科学基金（2014CFB473）
更新日期/Last Update: 2016-04-30