MR imaging-guided minimally invasive surgery for treament of posterolateral lumbar disc herniation via facet joint medial route
10.3760/cma.j.issn.1005-1201.2010.05.014
- VernacularTitle:MR导引小关节内缘入路微创治疗后外侧型腰椎间盘突出症
- Author:
Chengli LI
;
Ming LIU
;
Lebin WU
;
Yubo Lü
;
Jie HUANG
;
Jiqing SONG
;
Shougang BAO
;
Zhenli QI
;
Qianqian CAO
;
Jing YU
- Publication Type:Journal Article
- Keywords:
Intervertebral disk displacement;
Ozone;
Magnetic resonance imaging;
Radiology,interventional
- From:
Chinese Journal of Radiology
2010;44(5):508-512
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the value of MR imaging-guided percutaneous lumbar discectomy and discolysis with oxygen-ozone mixture for treatment of posterolateral lumbar disc herniation via a new puncture approach of facet joint medial route. Methods All 114 lumbar intervertebral discs in 103 patients were diagnosed as posterolateral lumber disc herniation by CT or MRI, which were located at the levels of L3-4 in 5 cases, LA-5 in 87 cases and L5-S1 in 22 cases. The procedure was guided under 0. 23 T open magnetic resonance with iPath 200 optical tracking system. A 14 G MR-compatible needle was punctured into the disc center via a new puncture approach of facet joint medial route. The therapy steps were as follows: firstly, cut nucleus pulposus and inject 6 ml oxygen-ozone mixture of 60 μg/ml in the disc center;secondly, retreat the needle to the local prominence, cut prominent part and inject 6 ml oxygen-ozone mixture of 60 μg/ml. Thirdly, retreat the needle to the periradicular nerve root, inject 15 ml oxygen-ozone mixture of 40 μg/ml and 4 ml pain-block liquid. All patients were followed up at 3 days, 1 month, 3 months and 6 months after operation, evaluated for the effect of treatment with the modified Macnab criteria, and the results were compared with the χ2 test. Results All procedures were successfully performed. Intraoperative dural injury occurred in 5 cases. Postoperative infection of intervertebral space occurred in 2 cases. The clinical effective rate was 96. 1% (99/103), 84.5% (87/103), 94.2% (97/103), 95.1% (98/103)respectively at 3 days, 1 month, 3 months and 6 months after operation, and the differences were signifieant (χ2 = 12. 942, P = 0. 005 ) . Conclusion MR imaging-guided percutaneous lumbar discectomy and discolysis with oxygen-ozone mixture via facet joint medial route is a minimally invasive, safety and effective method for the treatment of posterolateral lumbar disc herniation.
