腰椎间盘突出症：微创治疗应达到何种程度？
Lumbar disk herniation: How far should efforts go to minimally invasive procedure?
作者信息
Mostofi Keyvan, Moghadam Babak Gharaei, Peyravi Morad, Khouzani Reza Karimi
机构信息
Department of Neurosurgery, Centre Clinical, Chirurgie de Rachis, Soyaux, France.
Department of Neurosurgery, Neurosurgical Clinic of Dr Gharaei, Tehran, Iran.
出版信息
J Craniovertebr Junction Spine. 2018 Oct-Dec;9(4):238-240. doi: 10.4103/jcvjs.JCVJS_70_18.
BACKGROUND
Minimally invasive surgery (MIS) of lumbar disk herniation allows avoiding less of a mess in crossing structures, reducing muscular and cutaneous scarring, postoperative pain, lengthy recovery times, and the rate of infection. The aim of this study is to explain our experience in MIS of disc herniation. We compare the outcome of three different surgical techniques used for the treatment of lumbar disc herniation.
MATERIALS AND METHODS
A total of 1147 patients have been operated from July 2008 to December 2015 for lumbar disk herniation by posterior endoscopic approach. Three hundred and seventy-nine patients underwent discectomy and herniectomy (DH), 557 patients have been operated by herniectomy (H), and 211 patients underwent only bone decompression (BD).
RESULTS
The results show 80.10%, 82.06%, and 84.02% excellent outcome, respectively, in BD, DH, and BD techniques.
CONCLUSION
Analysis of the data demonstrates that the results obtained are equivalent and comparable in different used techniques for the treatment of disc herniation, we do not need to perform discectomy in all cases in a systematic way.
背景
腰椎间盘突出症的微创手术（MIS）可以减少对交叉结构的干扰，减少肌肉和皮肤瘢痕形成、术后疼痛、缩短恢复时间并降低感染率。本研究的目的是阐述我们在椎间盘突出症微创手术方面的经验。我们比较了用于治疗腰椎间盘突出症的三种不同手术技术的结果。
材料与方法
2008年7月至2015年12月，共有1147例患者接受了后路内镜下腰椎间盘突出症手术。379例患者接受了椎间盘切除术和疝切除术（DH），557例患者接受了疝切除术（H），211例患者仅接受了骨减压术（BD）。
结果
结果显示，BD、DH和BD技术的优良率分别为80.10%、82.06%和84.02%。
结论
数据分析表明，在治疗椎间盘突出症的不同使用技术中获得的结果是等效且可比的，我们无需在所有病例中都系统地进行椎间盘切除术。
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