CAJ | 학술논문

目的探讨经显微镜直视下小切口椎间盘摘除术治疗腰椎间盘突出症的手术方法及技巧,探索脊柱微创手术的新方法,以期提高手术疗效.方法 64例腰椎间盘突出症患者,在显微镜直视下行经后路腰椎间盘突出髓核摘除术.实际手术节段74个间隙,其中后外侧突出38个间隙,中央型突出32个间隙,极外侧突出4个间隙.结果全部病例均获得随访,随访时间6～8个月,平均7个月.按Nakai标准评定,其中优54例,良6例,可4例,差0例,优良率93.75%.术后无复发病例,无神经根损伤、硬膜囊撕裂等并发症.结论显微镜直视下腰椎间盘摘除术具有立体感强、视野好、手术创伤小、疗效佳的优点.虽然存在着手眼分离,但稍加训练即能胜任.在显微镜直视下行椎间盘髓核摘除术是目前治疗腰椎间盘突出症的最佳选择.
목적 탐토경현미경직시하소절구추간반적제술치료요추간반돌출증적수술방법급기교,탐색척주미창수술적신방법,이기제고수술료효.방법 64례요추간반돌출증환자,재현미경직시하행경후로요추간반돌출수핵적제술.실제수술절단74개간극,기중후외측돌출38개간극,중앙형돌출32개간극,겁외측돌출4개간극.결과 전부병례균획득수방,수방시간6～8개월,평균7개월.안Nakai표준평정,기중우54례,량6례,가4례,차0례,우량솔93.75%.술후무복발병례,무신경근손상、경막낭시렬등병발증.결론 현미경직시하요추간반적제술구유입체감강、시야호、수술창상소、료효가적우점.수연존재착수안분리,단초가훈련즉능성임.재현미경직시하행추간반수핵적제술시목전치료요추간반돌출증적최가선택.
Objective To explore operation method,skills,and curative effect of orthophofia microscope discectomy(OMD)for the treatment of lumber disc herniation.Method Retrospective analysis of the 64 patients(74 herniated discs)of lumbar disc herniation heated by OMD,which included 38 segments posterior-lateral extrusion,32 segments central type herniated,and 4 segments extra-lateral extrusion.Resuits All patients were followed-up 6 to 8 months,average 7 months,54 cases were good and 4 cases were fair and no case was bad according to the Nakai scale.The choiceness rate was 93.75%,and no serious complications.Conclusions Orthophoria microscope discectomy has a better third dimension,good operation field of vision,less invasion and best clinical curative effect.Orthophoria microscope discectomy may be the best way of discectomy for the treatment of lumber disc hemiation.