Chen Zhi-Guang, Fu Qin
Department of Orthopaedic Surgery, Shengjing Hospital, China Medical University, Shenyang 110004, Liaoning, China.
Zhongguo Gu Shang. 2012 Dec;25(12):1057-60.
Compared with open surgery, percutaneous transforaminal endoscopic discectomy (PTED) for lumbar disc herniation (LDH) has advantages of minamilly invasive, little impact on stability of spine and rapid recovery. However, PTED by transforaminal approach has relatively limited indications and can not completely replace open surgery, due to different location of migrated herniated fragment, the level of pathological segment or presence of a high iliac crest. Development of new approach and ancillary equipment have become the focus and future direction of PTED. In recent years, interlaminar and transiliac approach extended the indications of PTED greatly. However, not-standard manipulation, improper selection of indications or surgical approach has been attributed to the main reason for failure in PTED surgery. In view of this, the paper summaries indications, different approaches and methods, clinical efficacy and complications of PTED.
与开放手术相比，经皮椎间孔镜下腰椎间盘切除术（PTED）治疗腰椎间盘突出症（LDH）具有微创、对脊柱稳定性影响小、恢复快等优点。然而，由于移位的突出碎片位置不同、病理节段水平或存在高髂嵴，经椎间孔入路的PTED适应证相对有限，不能完全取代开放手术。新入路和辅助设备的开发已成为PTED的重点和未来方向。近年来，椎板间和经髂骨入路大大扩展了PTED的适应证。然而，操作不规范、适应证或手术入路选择不当被认为是PTED手术失败的主要原因。鉴于此，本文总结了PTED的适应证、不同入路和方法、临床疗效及并发症。
