应用椎间孔镜TESSYS技术治疗腰椎间盘突出症首都医科大学学报2012年12月摇摇摇第33卷摇第6期摇摇JournalofCapit摇摇摇摇摇Dec2012摇摇Vo1郎33摇No郎6alMedicall!niversity?临床研究？[doi:10哪3969/jissn朗1006郅7795哪2012哪06朗025]应用椎间孔镜TESSYS技术治疗腰椎间盘突出症11*1112刘昊楠摇林摇欣摇潘海涛摇闫家智摇崔摇维摇艾依热提？买买提1首都医科大学附属北京天坛医院骨科，北京100050;2新疆油IB公司明园职工医院外科，乌鲁木齐830000揖摘要錶摇目的摇评估经皮椎间孔镜transforaminalendoscopicspincsystcm,TESSYS技术治疗腰椎间盘突出的临床疗效，总结临床经验。方法摇2010年8月~2011年5月应用经皮椎间孔镜TESSYS技术治疗腰椎间盘突出症患者42例，其中男22例，女20例，患者平均年龄395岁20岁〜67岁，平均病程11个月3个月~6年。所有患者均为单间隙突出，突出间隙：L3/43例，L4/526例，L5/S113例。手术效果按照视觉疼痛模拟评分visualanaloguescale,VAS、J0A评分JapaneseOrthopaedicAssociationScores、0swestry功能障碍指数Oswcstrydisabilityindex,ODI和改良MacNab标准进行评定。结果摇所有患者均成功实施手术。平均手术时间70min55〜120min，术中出血量5~15mL。术后3例患者出现下肢神经感觉界常；3例患者术后症状即刻缓解，岀院后症状加重；1例患者术后症状缓解不明显，所有患者均经保守治疗后恢复正常或症状好转。无患者出现感染、血管、神经损伤和硬脊膜破裂等合并症。术后随访时间9个月。腰痛、腿痛VAS评分由术前58依14分、74依22分减少到术后9个月时的16依09分、14依02分，术后不同随访时间点VAS评分与术前比较明显改善P005oJ0A评分由术前121依37分升高至术后9个月时的225依21分，ODI由术前6883依1418%下降至术后9个月时2102依1134%o根据改良MacNab标准，术后末次随访时优12例286%,良25例595%，可4例95%，差1例24%，优良率881%o结论摇经皮椎间孔镜TESSYS技术是治疗腰椎间盘突出症安全、有效的手术方法。揖关键词钺摇经椎间孔；内窥镜；微创治疗；腰椎间盘突出症揖中图分类号铁摇R6815Transforaminalendoscopicspinesysteminpercutaneouslransforaminalendoscopicdiscectomyforlumbardischerniation11*1112LIUHaonan,L1NXin,PANHaitao,YANJiazhi,CUTWei,Aiyireti?MaimaitiIDcpartmcntofOrthopaedics,BeijingTiantanHospita1,CapitalMedicalUniversity,Beijingl00050,China;2DepartmentofSurgery,MingyuanHospitalofThePcrsonnel,XinjiangPetrolicCompany,Urumqi830000,China揖Abstract银摇0bjectivc摇TocvaluatctheefficacyofthetransforaminalendoscopicspinesystemTESSYSpercutaneoustransforaminalendoscopictechniquefortreatmentoflumbarclischerniationMcthods摇FromAugust2010toMay2011,42casesoflumbardischerniationwithaverageageof395yearsrange,2062yearswhounderwentpercutaneousendoscopicsurgerywereincludedinthisretrospectivestudy0fthe42cases,22weremalesand20femalesThemeancourseofdiseasewasllmonthsrange,3months6yearsTheinvolvedsegmentswereL3/4in3cases,L4/5in26cascs,andL5/Slini3casesThesurgerywasperformedunderlocalanesthesieiThevisualanaloguescaleVAS,JapaneseOrthopaedicAssociationJ0AScores,Oswestrydisabilityindex0DIandmodifiedMacNabcriteriawereemployedtomeasurethcclinica1outcomeRcsuIts摇Theoperationwassuccessfulina1lthecasesThemeanoperationtimewas70minrange,55120minwiththebloodlossof5^15mL0nly3caseswerefoundcomplicatedwithtransientparaesthesiainlowerlimbsAnother3casessufferedfromlegpciinrecurrenceafterreliefandlcasehadnosignificantre1iefA11thcseproblemswercrclicvedaftcrtheconservativetreatmentTherewerenoinfection,dura1mattertearandintraoperativeneurovascularinjuryinanyofthecasesThemeanfol1ow-upperiodwas9monthsThepreoperativcmcanVASoflowbackandlegpaindecreasedfro58依14and74依22pointsto16依09and14依02pointsat9thmonthpostopcrativclyThcJOAscoresincreasedfrom121依3...