文档介绍：XX大学毕业论文内窥镜下治疗复发性腰椎间盘突出症姓名: 2014年6月25日内窥镜下治疗复发性腰椎间盘突出症作者:张亚东,张向阳,王嘉,曹徳良【关键词】复发性腰椎间盘突出症;MED摘要:[目的]探讨对复发性腰突症患者行显微内窥镜下髓核切除术(microendoscopicdiscectomy,MED)治疗的可行性及有效性。[方法]19例有不同初次手术史,已明确诊断为复发性腰突症的患者接受MED手术。[结果]除1例术屮改为开放式外,18例均在MED方式下完成手术。全部18例得到随访05〜25a,平均随访15a。ab评分,优为7例,良为9例,可为2例,差为0例,优良率8889%oJOA评分由术前平均(961±340)分提高到末次随访时平均(2617±260)分,有效率为8632%o[结论]对于术前影像学上无明显腰椎不稳的复发性腰突症患者,只要遵循微创手术原则,掌握微创手术技巧,操作仔细,MED术也是治疗复发性腰突症较好的有效方法Z—。关键词:复发性腰椎间盘突出症; MEDAbstract:[Objective]Toinvestigatethesurgicalfeasibilityandefficiencywithmicroendoscopydiscectomytechniquefortherecurrentlumbardischerniation[Method]Ninteencasesunderwentdiscexcisionwithdifferentoperativeapproaches,11caseshadundergoneprevioussurgerywithMED,7caseswithconventionalapproach,2casesremovingwholevertebrateplateapproach,3casesremovinghalfvertebrateplateapproach,2caseswithminorvertebrateplatewindowapproachTherewere13casesofipsilateralprotrusionand2casesofcontralateralprotrusion,3casesofadjacentsegmentprotrusionAllofthesecaseswererevisionedbyMEDexceptfor1case[Result]essfullyexceptfor1casewhichwaschangedtoopenoperatingAllcaseswerefollowedupfrom6monthsto25years,averaged15yearsPostoperativeJOAscorewasimprovedfrompreoperativeaverage(961±340)°toaverage(2617±260)°,therateofimprovementfinalwas8632%abscoringsystem,thesatisfactoryratewas8889%[Conclusion]MEDtechniqueisaneffectivemethodforrecurrentlumbarherniation,buttheoperatorneedslotsofexperiencein