Oldenkott P, Roost D V
Neurochirurgie. 1980;26(3):229-34.
Meant by the microsurgical treatment of syndromes of lumbar nerve root compression caused by disk herniation, is the simultaneous use of a microsurgical, monosegmental access, and the execution of the operation by means of the operation microscope. Based on our own experience over more than 3 years, we describe the technique of the microsurgical access, as well as the procedure in 67 cases of lumbar disk herniation. The advantages, but also the risks of this surgical method are mentioned, and the indication for microsurgical treatment of lumbar disk herniations is commented on. Advantages are the reduced trauma of the dorsal musculature, and the improved ability to preserve tissue by use of the microscope with it's excellent illumination and magnification of the operation field. Compared with the conventional method, markedly lesser wound pain, as well as rarer micturitional disturbances, are observed postoperatively. Long term results have only been infrequent up to now. There-fore, the microsurgical treatment of lumbar disk herniation, despite it's undeniable advantages, cannot be viewed as an alternative to the hitherto practiced conventional operating methods. In these methods a magnification technique (telescope glasses), focusable light sources and perfectionized instruments can also enable us to keep the operational access restricted.
椎间盘突出所致腰神经根受压综合征的显微外科治疗，是指同时采用显微外科单节段入路，并借助手术显微镜实施手术。基于我们自身超过3年的经验，我们描述了显微外科入路技术以及67例腰椎间盘突出症的手术过程。文中提及了这种手术方法的优点及风险，并对腰椎间盘突出症显微外科治疗的适应证进行了评论。优点在于对背部肌肉组织的创伤减小，并且借助具有出色照明和手术视野放大功能的显微镜，保留组织的能力得到提高。与传统方法相比，术后观察到伤口疼痛明显减轻，排尿障碍也较少见。到目前为止，长期效果并不常见。因此，尽管腰椎间盘突出症的显微外科治疗具有不可否认的优点，但不能将其视为迄今所采用的传统手术方法的替代方法。在这些传统方法中，放大技术（望远镜眼镜）、可聚焦光源和完善的器械同样能使我们限制手术入路。
