Chumnanvej Sorayouth, Kesornsak Withawin, Sarnvivad Prasert, Paiboonsirijit Sompoch, Kuansongthum Verapan
Division of Neurosurgery, Surgery Department, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2011 Dec;94(12):1465-70.
To present the surgical outcome of the full-endoscopic lumbar discectomy via interlaminar approach.
Analysis of the prospectively collected data. The indication for full endoscopic discectomy is the same as for microscopic discectomy. Sixty consecutive patients with lumbar disc herniation were included. Full-endoscopic discectomy via interlaminar approach were done in all cases. The Visual analog scale (VAS), Thai version of modified Oswestry Disability Index (ODI), Macnab score, neurological symptoms, and complications were collected and followed for two years.
Mean follow-up period was 26 months. Excellent outcomes as defined by Macnab criteria were found in fifty-five of sixty patients (91.6%). The authors found two cases of recurrent disc herniation, which were re-operated by the same method and the symptoms were completely resolved later in the follow up period. There were two cases of persistent radicular pain after the operation, which were completely resolved after selective epidural nerve root injection. There was no serious neurological deficit, dura tear, or cauda equina syndrome in the present study series.
Full-endoscopic lumbar discectomy is a safe and effective procedure for lumbar disc herniation. Patients can expect less postoperative pain, early recovery, and a short period of work absence. However, the learning curve is steep. Proper surgical training and careful patient selection in the early cases are the keys to success.
介绍经椎板间隙入路全内镜下腰椎间盘切除术的手术效果。
对前瞻性收集的数据进行分析。全内镜下椎间盘切除术的适应证与显微椎间盘切除术相同。纳入60例连续的腰椎间盘突出症患者。所有病例均采用经椎板间隙入路全内镜下椎间盘切除术。收集视觉模拟评分（VAS）、泰国版改良奥斯威斯利功能障碍指数（ODI）、Macnab评分、神经症状和并发症，并随访两年。
平均随访时间为26个月。60例患者中有55例（91.6%）根据Macnab标准获得了优秀的手术效果。作者发现2例复发性椎间盘突出症，采用相同方法再次手术，症状在随访后期完全缓解。术后有2例持续性神经根性疼痛，经选择性硬膜外神经根注射后完全缓解。本研究系列中未出现严重神经功能缺损、硬脊膜撕裂或马尾综合征。
全内镜下腰椎间盘切除术是治疗腰椎间盘突出症的一种安全有效的方法。患者术后疼痛较轻，恢复较早，误工时间短。然而，学习曲线较陡。早期病例进行适当的手术培训和仔细的患者选择是成功的关键。
