Curative effects of microendoscopic discectomy for lumbar disc herniation
- VernacularTitle:显微内镜髓核摘除术治疗腰椎间盘突出症
- Author:
Jianhua HUANG
;
Ming CHEN
- Publication Type:Journal Article
- Keywords:
Lumbar disc herniation;
Spinal stenosis;
Microendoscopic discectomy
- From:
Chinese Journal of Minimally Invasive Surgery
2005;0(12):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze clinical effects of microendoscopic discectomy in the treatment of lumbar disc herniation with or without lumbar spinal stenosis.Methods A total of 216 patients were included in the study.The patient was maintained in the prone position on an arch-like bed.Under C-arm fluoroscopic guidance,a thin pin was inserted down to the facet of the target level.A longitudinal incision was made approximately 1.7 cm at the level of the disease to introduce a series of dilators,over which a working channel was then established.Once extraneous soft tissues were removed,a curette was used to puncture the ligamentum flavum.And the local ligamentum flavum and part of inferior border of the adjacent lamina were removed with a gun-shaped rongeur.The disc space was incised and a discectomy was performed.The lateral recess was cleared of any bone stenosis.Results conversions to open traditional discectomy were conducted in 2 patients because of bleeding.The 216 patients were followed for 3 months ~ 4 years with an average of 2.5 years.According to the Nakai criteria,excellent outcomes were achieved in 210 patients,good in 2 patients,fair in 1,and poor in 3,the rate of excellent or good outcomes being 98.1%(212/216).Of the 3 patients with poor outcomes,2 patients were given a re-operation of traditional surgery 3 months after the microendoscopic discectomy and 1 patient had a missed diagnosis of spinal tuberculosis.Conclusions Microendoscopic discectomy in the treatment of lumbar disc herniation gives little influence to spinal stability and satisfactory clinical effects.
