CAJ | 학술논문

目的：探讨经横突间入路显微内窥镜下髓核摘除（MED）治疗极外侧型腰椎间盘突出症的临床效果。方法：对2005年2月至2010年2月经横突间入路显微内窥镜下髓核摘除治疗的极外侧型腰椎间盘突出症73例患者进行回顾性分析，其中男41例，女32例；年龄19～80岁，平均56．5岁；病程1～25个月，平均4．5个月。突出间隙：L3，49例，L4，549例，L5S115例。记录术前、术后2周及末次随访时疼痛强度视觉模拟评分（visualanaloguescale，VAS），评估患者疼痛缓解情况。采用Oswestry功能障碍指数（OswestryDisabilityIndex，ODI）评价患者术前和末次随访时躯体功能、行走能力等总体生活质量。结果：所有患者手术顺利完成，手术时间40～115min，平均50min；出血量50～150ml，平均110ml；切口感染1例，神经根不完全损伤1例。73例均获随访，时间3～8年，平均4．5年。术后VAS及ODI分值均较术前有明显改善（P＜0．01）。结论：经横突间入路显微内窥镜下髓核摘除术是治疗极外侧型腰椎间盘突出症有效可行的方法。
목적：탐토경횡돌간입로현미내규경하수핵적제（MED）치료겁외측형요추간반돌출증적림상효과。방법：대2005년2월지2010년2월경횡돌간입로현미내규경하수핵적제치료적겁외측형요추간반돌출증73례환자진행회고성분석，기중남41례，녀32례；년령19～80세，평균56．5세；병정1～25개월，평균4．5개월。돌출간극：L3，49례，L4，549례，L5S115례。기록술전、술후2주급말차수방시동통강도시각모의평분（visualanaloguescale，VAS），평고환자동통완해정황。채용Oswestry공능장애지수（OswestryDisabilityIndex，ODI）평개환자술전화말차수방시구체공능、행주능력등총체생활질량。결과：소유환자수술순리완성，수술시간40～115min，평균50min；출혈량50～150ml，평균110ml；절구감염1례，신경근불완전손상1례。73례균획수방，시간3～8년，평균4．5년。술후VAS급ODI분치균교술전유명현개선（P＜0．01）。결론：경횡돌간입로현미내규경하수핵적제술시치료겁외측형요추간반돌출증유효가행적방법。
Objective:To explore the clinical effect of intertransverse approach microendoscopic discectomy for far lateral lumbar disc herniation. Methods:From February 2005 to February 2010,73 patients with far lateral lumbar disc herniation were treated with intertransverse approach microendoscopic discectomy. Their clinical data were retrospectively analyzed. There were 41 males and 32 females,aged from 19 to 80 years old with an average of 56.5 years;courses of disease ranged from 1 to 25 months with an average of 4.5 months. The main symptom was low back pain and sciatica ,especially the sciatica was seriously. Herniation level was in L3,4 of 9 cases,L4,5 of 49 cases,L5S1 of 15 cases. Preoperative,2 weeks after operation,final follow up,conditions of pain relief were assessed by visual analogue scale (VAS);total life quality of patients were evaluated by Oswestry Disability Index (ODI) before operation and last follow up. Results:All operations were performed successfully, operative time was from 40 to 115 min (mean of 50 min);and blood loss was from 50 to 150 ml (mean of 110 ml). Incision in-fection had 1 case and incomplete nerve root injury had 1 case. All patients were followed up from 3 to 8 years with an average of 4.5 years. Postoperative VAS and ODI had obviously improved (P<0.01). Conclusion:The technique of intertransverse ap-proach microendoscopic discectomy is a feasible and effective method for far lateral lumbar disc herniation.