Weiner B K, Walker M, Brower R S, McCulloch J A
Department of Orthopaedic Surgery, Summa Health Systems, Akron, Ohio, USA.
Spine (Phila Pa 1976). 1999 Nov 1;24(21):2268-72. doi: 10.1097/00007632-199911010-00016.
A description of the technique for lumbar microdecompression and a prospective study of the outcomes.
To describe and analyze a technique that affords an excellent decompression while minimizing damage to surrounding tissues.
Commonly used techniques of lumbar decompression that include bilateral takedown of paraspinal musculature and aggressive bony resection can result in significant iatrogenic sequelae. A less destructive alternative is needed.
Unilateral limited takedown of multifidus was undertaken, and ipsilateral decompression performed. The contralateral side then was addressed under the midline structures with microscopic visualization--thereby preserving the supra-/interspinous ligament complex and the contralateral musculature. Thirty consecutive patients undergoing the procedure were analyzed prospectively and after a follow-up period by independent observers using a modified validated functional outcome score and patient satisfaction measures.
The technique affords an excellent decompression while minimizing destruction to tissues not directly involved in the pathologic process. Functional outcome scores doubled, and 87% of patients reported high satisfaction rates.
Lumbar microdecompression is a minimally invasive technique that appears to provide excellent functional outcomes.
腰椎微减压技术的描述及结果的前瞻性研究。
描述并分析一种能实现良好减压同时将对周围组织的损伤降至最低的技术。
常用的腰椎减压技术，包括双侧切除椎旁肌肉组织和积极的骨质切除，可能导致严重的医源性后遗症。需要一种破坏性较小的替代方法。
进行多裂肌单侧有限切除，并进行同侧减压。然后在显微镜直视下处理中线结构下方的对侧，从而保留棘上/棘间韧带复合体和对侧肌肉组织。对连续30例接受该手术的患者进行前瞻性分析，并在随访期后由独立观察者使用改良的有效功能结局评分和患者满意度测量方法进行评估。
该技术能实现良好减压，同时将对未直接参与病理过程的组织的破坏降至最低。功能结局评分翻倍，87%的患者报告满意度高。
腰椎微减压是一种微创技术，似乎能提供良好的功能结局。
