【摘要】 目的　报道内视镜协助下腰椎管减压、椎间盘摘除术治疗腰椎管狭窄伴椎间盘突出的方法。方法　将内视镜置于脊柱后正中切口内 ,在内视镜放大影像和直视相结合下操作。治疗 2 6例 ,切除全椎板 5个、半椎板 2 0个 ,扩大开窗 9个 ,摘除椎间盘 30个。结果　 2 6例均获 2～ 18个月随访 ,平均9 5个月。优 2 3例 ,良 3例 ,优良率 10 0 % (2 6 / 2 6 )。结论　内视镜协助下腰椎管减压、椎间盘摘除术具有以下优点 :①切口小、出血少、相对微创、恢复快。②利用内视镜观察和操作可弥补直视手术观察的盲区。将血管、神经放大 5倍下操作更安全。有利于发现突出的椎间盘及椎管内占位 ,防止遗漏。③术中同步录像便于分析总结、示教及存档 ,使手术从经验型逐步走向科学型更多还原

【Abstract】 Objective To report a method for the laminectomy and removal of lumbar intervertebral disc using an endoscope to treat lumbar vertebral canal stenosis accompanied by lumbar intervertebral disc herniation. Methods The operation was performed through a posteromedian skin incision with the aid of an endoscope coupled with a television and video unit. 26 patients were treated. There were 5 total laminectomy; 20 semi laminectomy; 9 enlarged fenestration. 30 ruptured discs were removed. Results All patients were followed up from 2 to 18 months averaged 9 5 months, 23 and 3 patients obtained excellent and good results respectively, and the excellent and good rate was 100%. Conclusion Minimal wound laminectomy and lumbar diskectomy with the aid of an endoscope has following advantages: ① Smaller incision and less hemorrhage, minimal wound and rapid recovery. ② The operation can dispel blind area of direct vision surgery through magnifying 5 times by an endoscope and protect blood vessel and nerves, and help find projecting disc and tumor in vertebral canal. ③ The operation videotape will benefit analysis, summary, teaching and keeping on a file of operation. The operation will transfer gradually from experience to science.更多还原