Graham C E
Orthopaedic Department, VMO Prince of Wales Hospital, Randwick, Sydney, Australia.
Clin Orthop Relat Res. 1989 Jan(238):104-6.
The evacuation and decompression of the herniated lumbar disc (HLD) through a sheath or cannula inserted dorsolaterally represent a new concept in the treatment of backache and sciatica associated with disc herniation. Under local anesthetic and Valium (Roche, Nutley, New Jersey) sedation, 20 patients with sciatica, restricted straight-leg raising, and neurological impairment were treated by this simple and safe technique. All patients had computed tomographic evidence of L4-L5 protrusion. The introduction of a sheath with an internal diameter of 4.9 mm permitted removal of the nuclear material by means of a small pituitary forcep. Using the self-assessment method of Coventry and Stauffer, it was concluded that 12 of the 20 patients had a good or fair result. Predictably, the compensation patients fared poorly. There were no complications. This technique appears applicable in HLD to properly selected patients, and it would seem that it is safe, effective, and cost efficient.
通过背外侧插入的鞘管或套管对腰椎间盘突出症（HLD）进行减压和髓核摘除，是治疗与椎间盘突出相关的背痛和坐骨神经痛的一种新概念。在局部麻醉和安定（罗氏公司，新泽西州纳特利）镇静下，采用这种简单安全的技术对20例患有坐骨神经痛、直腿抬高受限和神经功能障碍的患者进行了治疗。所有患者均有L4-L5椎间盘突出的计算机断层扫描证据。引入内径为4.9毫米的鞘管后，可用小型垂体钳摘除核物质。采用考文垂和斯托弗的自我评估方法得出结论，20例患者中有12例效果良好或尚可。可以预见，有赔偿要求的患者效果较差。无并发症发生。该技术似乎适用于经适当选择的HLD患者，看起来安全、有效且具有成本效益。
