摘要
目的:探讨显微内窥镜下椎间盘切除术(MED)治疗MED术后复发性腰椎间盘突出症的可行性和有效性。方法:2000年10月～2006年5月1572例腰椎间盘突出症患者进行MED治疗,术后9～61个月8例患者出现同节段典型的神经根损害症状和体征,MRI和CT证实为腰椎间盘突出。男5例,女3例,年龄25～47岁,平均35.6岁。均再次行单侧MED手术,其入路和经过与常规MED相似。结果:8例患者的神经根显露和减压良好,无转为开放手术病例。平均手术时间68min,平均失血量45ml,平均住院12.7d。1例术中发生脑脊液漏,无其它并发症。随访5～46个月,平均20.8个月,采用改良Macnab标准评价临床效果,优5例,良3例。结论:对于首次MED术后复发性腰椎间盘突出症患者,再次行MED仍是安全有效的治疗方法。
Objective：To explore the feasibility and efficiency of mieroendoscopic discectomy（MED） for recurrent lumbar disc herniation after MED.Method：From October 2000 to May 2006, 1572 patients with lumbar disc herniation were treated by MED.Classic symptoms and signs of lumbar radiculopathy occurred in 8 patients at the same level in 9-61 months postoperatively,Recurrent lumbar disc herniation was verified by magnetic resonance imaging and compnter tomography,There were 5 males and 3 females,ages ranged from 25 to 47 years,average age 35.6 years,The second unilateral MED was performed on all patients,the approach and process were similar to the standard MED.Eight consecutive patients underwent line procedure were analyzed retrospectively.Result：The excellent visualization and decompression of the nerve root were obtained in all patients,No any conversion to open procedures happened.The average operative time was 68 minutes,with a mean blood loss of 45ml and mean hospital stay of 12.7 days,Besides one cerebrospinal fluid leakage,there was no other complications.At meant follow-up of 20.8 months（range,5-46 months）.the clinical outcomes were determined using a modified Maenab criteria,which revealed that 5 patients had excellent resuh,3 had good. Conclusion：For recurrent lumbar disc herniation after the primary MED.the second MED is still a safe and effective surgical method.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
2007年第5期350-353,共4页
Chinese Journal of Spine and Spinal Cord
