MED治疗中央型腰椎间盘突出症远期随访.docVIP

MED治疗中央型腰椎间盘突出症远期随访 　　[摘要] 目的:探讨中央型腰椎间盘突出症双侧行后路内窥镜下腰椎间盘髓核摘除术(MED)的远期临床疗效,以了解MED治疗中央型腰椎间盘突出症的临床应用价值。方法:对本院2002年2月至2004年6月收治的23例中央型腰椎间盘突出症经双侧行MED手术治疗的患者进行随访,并采用ODI量表及MacNab评分对疗效进行评定。结果:随访的19例患者中,男14例,女5例,随访时间为60～84个月,平均72.8个月,ODI为0～14,平均4.6,优良率84.2%,按照MacNab评分,有效率94.7%。结论:应用脊柱后正中入路双侧行MED治疗中央型腰椎间盘突出症,疗效显著。? 　　[关键词] 内窥镜下椎间盘髓核摘除术; 腰椎间盘突出症; 中央型 　　[中图分类号] R681.53; R730.49 [文献标识码] A [文章编号] 1671-7562(2010)04-0385-03? 　　doi:10.3969/j.issn.1671-7562.2010.04.021?? 　　 　　Long-term outcomes of microendoscopic discectomy for central ?type of lumbar disc herniation?? 　　XIE Ling-han?1, WU Xiao-tao?2, WANG Chen?2, MAO Zu-bin?2, CHEN Hui?2, LI Yong-gang?2 　　(1. Medical College of Southeast University, Nanjing 210009, China; 2. Department of Orthopaedics, Zhongda Hospital, Southeast University, Nanjing 210009, China)?? 　　[Abstract] Objective: To observe long-term clinical effect of microendoscopic discectomy for central type of lumbar disc herniation, to confirm the clinical value of microendoscopic discectomy in treatment of central type of lumbar disc herniation. Methods: 23 cases with central type of lumbar disc herniation treated by microendoscopic discectomy were followed, the outcomes were estimated by ODI and the MacNab?s criteria. Results: 19 cases were followed up for 72.8 months (range 60-84 months), there were 14 males and 5 females, average ODI score was 4.6(range 0-14), efficient was 84.2%. According to MacNab?s criteria, efficient was 94.7%. Conclusion: The effect of microendoscopic discectomy for central type of lumbar disc herniation is excellent.? 　　[Key words] microendoscopic discectomy; lumbar disc herniation; central type?? 　　 　　 腰腿痛是临床常见病,而腰椎间盘突出(lumbar disc herniation, LDH)是导致腰腿痛的主要原因。传统治疗LDH的主要方法是开放手术,行椎板(半椎板)切除摘除椎间盘。后路内窥镜下腰椎间盘髓核摘除术(microendoscopic discectomy,MED)是一种新兴的治疗LDH的微创手术方式,其诞???不过十余年,但是其相对于传统的椎板(半椎板)切除摘除椎间盘手术具有的创伤小、恢复快、疗效佳等优点[1],使得其在诞生后短短数年即在国内外广泛开展。我院自十年前采用枢法模公司的显微内窥镜系统(METRx)进行手术以来,已进行三千余例,其中包括MED治疗单节段、多节段、中央型手术。本研究对双侧行MED治疗的双侧根性症状的中央型LDH患者