经皮侧后路腰椎间孔成形手术器械的设计及临床应用

被引：46

作者：

李振宙

吴闻文

侯树勋

商卫林

机构：

[1] 解放军总医院第一附属医院骨科

来源：

中华骨科杂志 | 2011年 / 10期

关键词：

腰椎; 内窥镜检查; 椎间盘移位; 椎间盘切除术,经皮;

D O I：

暂无

中图分类号：

R687.3 [骨骼手术];

学科分类号：

100220 [骨科学];

摘要：

目的介绍经皮侧后路腰椎间孔成形手术器械的研制,分析经皮腰椎间孔成形、经椎间孔内镜下椎间盘摘除术治疗非包含型腰椎间盘突出症的长期疗效。方法应用自制经皮侧后路腰椎间孔成形器械,以腰椎间孔扩大成形、经椎间孔内镜下椎间盘摘除术治疗56例非包含型腰椎间盘突出症患者:L3-4节段7例,L4-5节段30例,L5S1节段19例。分析治疗前及治疗后36个月内腰痛及腿痛视觉模拟评分（visual analogue scales,VAS）的变化及术后36个月时的Macnab功能评分。结果 56例手术均顺利完成,手术时间40～120 min（平均60 min）,术中出血量20～50 ml（平均30 ml）。56例患者术后至少随访36个月。腰痛VAS:术前（6.5±2.3）分,术后1天（2.2±1.3）分,术后3个月（1.8±1.5）分,术后12个月（1.4±1.3）分,术后36个月（1.5±1.2）分;下肢放射痛VAS:术前（8.7±2.3）分,术后1天（1.2±0.8）分,术后3个月（0.7±0.6）分,术后12个月（0.5±0.3）分,术后36个月（0.8±0.5）分;术后各时间点较术前均明显降低（P<0.01）。按照Macnab评分标准,36个月随访时,44例优,10例良,2例可,优良率为96.4%。仅5例于术后1周出现下肢"日光烧灼综合征",均为L5S1椎间盘突出症患者,经过脉冲电刺激治疗1周后缓解。无其他手术并发症发生。结论经皮腰椎间孔成形、经椎间孔内镜下椎间盘摘除术是非包含型腰椎间盘突出症的有效、安全的微创治疗方法。

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