椎间孔镜治疗脱出型腰椎间盘突出症19例

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1、·876·JOurnalofPracticalOrthopaedicsVo1．18，No．10．Oct．2012文章编号：1008—5572(2012)10—0876—04椎间孔镜治疗脱出型腰椎间盘突出症19例隰建成，马远征，崔旭，胡明，刘向东，白一冰(解放军第309医院骨科，北京100091)摘要：目的探讨椎问孔镜治疗脱出型腰椎问盘突出症的疗效、围手术期并发症及处置对策。方法选择自2009年11月至2011年5月在我院应用椎问孔镜治疗的19例随访资料完整的脱出型腰椎间盘突出症患者，随访时间6个月～2年，平均随访13个月，比较术前、术后即刻、l周、

2、3个月、6个月、12个月、22个月的JOA、VAS及Oswestry(2．0版本)评分，分析术中、术后并发症的情况，并探讨处置对策。结果l9例患者术后JOA评分较术前明显升高，术后VAS和Oswestry评分较术前明显降低，有统计学意义(

3、和谨慎的术中操作可预防或减少并发症的发生。关键词：椎问孔镜；经皮椎间盘切除；脱出型腰椎间盘突出；疗效；并发症中图分类号：R681．53文献标识码：BTreatmentof19CasesofProlapsedLumbarDiscHerniationbyTransforaminalEndoscopicSpineSystem(TESSYS)X1JJan—cheng，MAYuanzheng，CUIXU，∈“(DepartmentofOrthopaedicsofPIA309thHospital，Beijing10009l，China)Abstract：Obj

4、ectiveFoinvestigatethetherapeuticeffect。compIicationsanddisposalstrategyOiltreatmentofprolapsedlumbardischerniationbytransforaminalendoscopicspinesystem(TESSYS)．MethodsFrom2009．11．to2011．05comparisonofpreoperativeandpostoperative，JOA，VASandOswestry(version2．0)scorewereperforme

5、dinprolapsedlumbardischerniationpatients．Theperi—operativecomplicationsanddisposalstrategymwereanalyzed．Thetimeoffollowupwas6months～2years．Theaveragetimeoffollowupwas13months．ResultsPostoperativeJOAscorewassignificantlyincreasedcomparedwithpreoperativescore(P<0．O1)．Postoperati

6、veVASandOswestryscoredecreasedsignificantlycomparedwithpreoperativescore(Pal0．01)．Thecommoncomplicationsduringopera—tionincludedthat1caseofIacerationofdura．1easeofcontusionofnerveroot，1caseofextraneOUsmaterialenteredvertebralcanaland1caseofguidepinbroken．Thecommonpostoperative

7、complicationsincluded1caseofparalysisofquadricepsfemoris，lcaseofinfection，lcaseofinjuryofcoccygealnerveandl2casesofpostoperativeedemare—sponse．ConclusionProlapsedlumbardischerniationcanbeeffectivelytreatedwilt1TESSYS，butthecomplicationsmayhappened．fhecomplicationscanbeprevente

8、danddiminishedbystrictperioperativedisposalandprudentmanipula