Endoscopic surgery with mobile endospine system for the sequested lumbar disc herniation
10.3760/cma.j.issn.0253-2352.2011.05.004
- VernacularTitle:可动式脊柱内镜技术治疗游离型腰椎间盘突出症
- Author:
Baoshan XU
;
Qun XIA
;
Ning JI
;
Qiang YANG
;
Yongcheng HU
;
Jun MIAO
;
Jidong ZHANG
- Publication Type:Journal Article
- Keywords:
Lumbar vertebrae;
Intervertebral disk displacement;
Endoscopy
- From:
Chinese Journal of Orthopaedics
2011;31(5):431-435
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy of mobile endospine system for sequested lumbar disc herniation.Methods From May 2007 to December 2009,31 patients of sequested lumbar disc herniation were treated with mobile endospine system,including 17 men and 14 women with a mean age of 46 years (32-59 years).Patients complained severe leg and low back pain with disability.According to MRI,the sequested nucleus herniated from the disc of L2-3 in 1 case,L3-4 in 1,L4-5 in 16 and L5S1 in 13;and the direction of herniation was caudal in 24 cases,cephalic in 6 and indistinguishable in 1.The patients were followed up for 12 months (range,6-24 months) ,and the results were evaluated according to Macnab scale.Results The procedure was technically successful in all the patients:the sequested nucleus was completely extracted.The protruded disc was treated with discectomy in 30 cases,and the nearly intact disc was left untouched in one patient.Among the 24 cases with caudal herniation,sequested nucleus situated ventrally beneath the dural theca and the transitional nerve root in 15 cases,between the nerve root and dural theca in 5,and dorsally on the nerve root and dural theca in 4.All the 6 cephalic herniation situated beneath the dural theca,1 of them reached the level of pedicle,and 2 herniated into the intervertebral canal.The sequested disc presented as indistinguishable signal on MRI included nucleus,annulus and cartilage endplate,and situated dorsally around the dural theca.The mean operative time was 50 min (range,40-70 min) with a mean blood loss of 80 ml (range,30-200 ml).There was no complication of nerve injury.Only too much facet was resected in 2 patients without clinical symptom.The results were excellent in 21 cases and good in 10 cases,and all of them were satisfied with this procedure.Conclusion The working canal and visual field of mobile endospine system is movable,so the sequested nucleus can be extracted completely with good results.
