Microendoscopic discectomy in the treatment of lumbar spinal stenosis in 44 elderly patients
- VernacularTitle:MED治疗老年腰椎管狭窄症44例体会
- Author:
Chao XU
- Publication Type:Journal Article
- Keywords:
Lumbar spinal stenosis;
Lumbar disc herniation;
Endoscopy;
Discectomy
- From:
Chinese Journal of Minimally Invasive Surgery
2001;0(01):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the value of posterior approach microendoscopic discectomy (MED) in the treatment of lumbar spinal stenosis. Methods In the light of preoperative localization by anterioposterior and lateral X-ray examinations of labeled lumbar vertebrae, the MED system was established under local anesthesia or epidural blockage. Part of lamina and hyperplastic and cohesive articular processes were removed by using a self-made osteotome to fully decompress the dura mater and nerve roots. Results The operation time ranged 25～180 min, with an intraoperative blood loss of 50～300 ml. A conversion to open surgery was required in 1 case because of widespread adhesions of the dura mater and nerve roots. All the 44 patients were followed for 3～40 months (mean, 15 months). According to Nakai criteria, 30 patients had an "excellent" result, 8 patients had a "good" result and 6 were classified as "poor", the rate of "good" or "excellent" results being 86.4% (38/44). Postoperative infection of intervertebral space and symptoms on healthy limbs were observed in 1 case and 2 cases, respectively. Conclusions MED has the advantages of minimal invasion, little blood loss and rapid recovery. It can offer both full decompression to nerves and the stability of spine to the greatest possible advantage, being an effective means in the treatment of lumbar spinal stenosis in elderly patients.
