ARTHROSCOPIC MICRODISCECTOMY

被引:103
作者
KAMBIN, P [1 ]
机构
[1] UNIV PENN,SCH MED,GRAD HOSP DISC TREATMENT & RES CTR,PHILADELPHIA,PA 19104
来源
ARTHROSCOPY | 1992年 / 8卷 / 03期
关键词
ARTHROSCOPIC MICRODISCECTOMY; SCIATICA;
D O I
10.1016/0749-8063(92)90058-J
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Follow-up examinations performed a minimum of 2 years postoperatively showed that no neurovascular complications developed in 100 patients who underwent arthroscopic microdiscectomy for treatment of herniated discs at L3-4, L4-5, or L5-S1. By using a posterolateral approach, endoscopic control, and specially designed straight, upbiting, and deflectable forceps, it was possible to remove not only fragments located in the center of the nucleus, but also fragments that had migrated posteriorly and posterolaterally. Analysis of operative results by a modification of the Rush-Presbyterian-St. Luke's lumbar spine analysis system demonstrated that 88 of the patients attained excellent or good results and 12 attained poor or fair results. The outcome of surgery was not related to age, sex, or surgical level. The most common causes of an unsuccessful surgical outcome were lateral recess stenosis and sequestered fragments missed in the preoperative work-up.
引用
收藏
页码:287 / 295
页数:9
相关论文
共 27 条
[1]  
Dandy, Loose cartilage from intervertebral disc simulating tumor of the spinal cord, Archives of Surgery, 19, pp. 660-672, (1929)
[2]  
Mixter, Barr, Rupture of the intervertebral disc with involvement of the spinal canal, N Engl Surg Soc, 211, pp. 210-215, (1934)
[3]  
Epstein, Lavine, Epstein, Recurrent herniation of the lumbar intervertebral disk, Clin Orthop, 52, pp. 169-178, (1967)
[4]  
Paus, Skalpe, Recurrence of pain following operation for herniated lumbar disc: fresh herniation or extradural scar tissue, Int Orthop, 3, pp. 133-136, (1979)
[5]  
Ramirez, Thisted, Complications and demographic characteristics of patients undergoing lumbar diskectomy in community hospitals, Neurosurgery, 25, pp. 226-231, (1989)
[6]  
Shinners, Hamby, Protruded lumbar intervertebral disc results following surgical and nonsurgical therapy, J Neurosurg, 6, pp. 450-458, (1949)
[7]  
Stolke, Sollman, Seifert, Intra- and postoperative complications in lumbar disk surgery, Spine, 14, pp. 56-59, (1989)
[8]  
Hult, Retroperitoneal disc fenestration in low back pain and sciatica, Acta Orthopaedica, 20, pp. 342-348, (1951)
[9]  
Smith, Enzyme dissolution of the nucleus pulposis in humans, JAMA, 187, pp. 137-180, (1964)
[10]  
Hijikata, Yamagishi, Nakayama, Et al., Percutaneous diskectomy: a new treatment method for lumbar disk herniation, J Toden Hosp, 5, pp. 5-13, (1975)