Abstract: 【Abstract】〓Objective〓To investigate the curative effect on the decompressive laminectomy and discectomy using x-tube operation system for the treatment of lumbar disc herniation. Method〓From Jan 2010 to Jun 2012, the clinical data of 36 patients with lumbar disc herniation were analyzed respectively. All cases.(including L4/5 in 20 cases,L5/S1 in 16 cases)underwent the surgical procedure of decompressive laminectomy and discectomy using x-tube operation system..The clinical effects were evaluated according to Nakai scale. The operative time, intraoperative blood loss, complications, pre- and post-operative VAS score and ODI score were observed. Result〓All patients were followed-up for an average of 18 months (range from 12 to30)..The patients were excellent results in 22, good in 12, fair in 2 according to Nakai scale. The operative time was 50 min (30-110 min), intraoperative blood loss were 43 ml(10-150 ml). The pre- and post-operative VAS score were 8.1±1.5 and 2.7±1.2. The average ODI score was decreased from 75.5±18.2% of pre-operation to 18.3±7.5% of post-operation..ODI score in 6 months and one year were lower than that in preoperation. Cutaneous necrosis occurred in one case and disruption of wound happened in one case. Conclusion〓The surgical procedure of decompressive laminectomy and discectomy using x-tube operation system for the treatment of lumbar disc herniation could achieve satisfactory clinical results based on strict operation indication and a definitive study curve.

Key words: Lumbar disc herniation, Treatment, Endoscope, X-tube

摘要： 【摘要】〓目的〓探讨经x-tube腰椎板开窗减压,髓核摘除术的临床效果。方法〓自2010年1月~2012年6月,36例腰椎间盘突出患者(L4/5椎间盘突出20例,L5-S1椎间盘突出16例)行经x-tube腰椎板开窗减压,髓核摘除术。按Nakai评分标准评价临床效果,同时记录手术时间、失血量、并发症、术前/后疼痛视觉模拟评分(VAS)、术前/术后末次随访时OSWESTRY功能障碍指数(ODI)评分。结果〓所有病例均得到随访,随访时间12~30个月,平均18个月。术后功能评定按Nakai评分级:优22例,良12例,可2例,优良率94.4%。手术时间30~110 min,平均50 min;术中失血量10~150 mL,平均43 mL;术前VAS评分为8.1±1.5分,术后为2.7±1.2分(P<0.05);术前ODI指数为75.5±18.2%,随访6个月ODI指数为18.3±7.5%,随访1年为18.1±7.6%;术前与术后6个月、术后1年ODI指数的差异有统计学意义(P<0.05)。术后出现1例患者伤口皮肤周围坏死,1例出现拆线后裂开,均给予对症换药及缝合治疗后愈合。结论〓经x-tube微创治疗腰椎间盘突出症,效果满意,术中失血少,术后康复快,但需要一定的学习曲线及掌握手术适应症。

关键词: 腰椎间盘突出症, 治疗, 内窥镜, X-tube