关键词: 腰椎间盘突出症, 内镜, 外科治疗, 效果

Abstract: Objective To analyze the value of percutaneous transforaminal endoscopic spine system (TESSYS) in lumbar discectomy for disc herniation. Methods Thirty one patients of lumbar disc herniation were treated with percutaneous transforaminal endoscopic discectomy and followed 6-12 months, included 27 men and 4 women, with a mean age of 39 years (range, 18-58 yrs). The involved level included L34 at 2 cases, L45 at 21 cases and L5S1 at 8 cases. Local anesthesia was used in all the patients, and targeted puncture was performed under fluoroscopic guidance. The foramen of involved level was enlarged gradually with four trephinations, and the working canal was introduced transforaminal into the canal. Then the herniation was exposed and removed with full endoscopic technique, including the loosen nucleus pulposus. The nerve root and thena was exposed and released adequately. Results The procedure was evenly carried out in 27 cases, with discetomy and nerve root release. For the first case of far lateral herniation and the second case, the nerve root was not exposed. Two cases converted to posterior microendoscopic discetomy, included one case of large herniation, and one woman who complained intraoperative pain. The patients could walk in 1-2 days after operation, with obvious relieve of leg pain. One recurrence at 2 weeks was treated conservatively, A the final follow-up, the visual analuge scale of leg pain decreased from 8.1±1.9 to 1.1±0.9, and the ODI decresed from 31±8 to 3.4±3. According to MacNab scale, excellent results were obtained in 25 cases and good results in 6 cases. Conclusion The percutaneous endoscopic TESSYS is a good technique for lumbar discectomy. Excellent or good results can be obtained with this minimal invasive technique, while a learning curve exists.

Key words: Lumbar disc herniation, Endoscopy, Surgery, Outcome