【摘要】 目的 探讨经后路椎间盘镜手术治疗合并腰椎管狭窄症的椎间盘突出症的临床应用。方法 采用后路椎间盘镜进行单侧开窗减压术。通过“C”形臂X线机或摄侧位X线片定位,于后正中作长约1.5cm小切口,逐级扩张后置入工作通道管,钻除部分椎板,置入内镜,于电视监视器下显露椎板、增生内聚的关节突、肥厚的黄韧带及突出的椎间盘髓核组织,彻底解除其对硬脊膜、神经根的压迫。结果 本组共治疗合并腰椎管狭窄症的腰椎间盘突出症23例,平均随访7个月,按Prolo标准评定,治愈20例,有效2例,无效1例。结论 本术式在严格掌握适应证前提下对合并腰椎管狭窄症的腰椎间盘突出症的患者效果明显。

    【关键词】 腰椎间盘突出症;内镜

    Analysis of lumbar disc herniation with lumbar spinal stenosis treated by posterior approah microendoscopic discectomy system

    GAO jin-liang,Gong Liang-tai,SUN Gang,et al.

    Department of Orthopedics,Qilu Hospital of Shangdong University,Jinan 250012,China

    【Abstract】 Objective To investigate clinical application and indication of posterior spinal approach microendoscopic discetomy system(MED).Methods MED was used to remove the elements(bony and disc) that were compressing the dural sac and nerve roots through an incision 2cm length under guidance of the“C”arm X - ray machine.Results 23 LDH patients with lumbar spinal stenosis undergone MED were followed up for 7 months,20 were evaluated as excellent,2 as good, 1 as failure.Conclusion The MED leads to less trauma to lumbar vertebrae and little influence on the stability of it. With strict selection of indication of MED for lumbar disc herniation with lumbar spinal stenosis,the evaluation of operation is excellent. ......