关键词: 椎间盘移位, 外科手术, 微创性, 经皮椎间孔镜腰椎间盘摘除术

Abstract: Objective To evaluate the effect of percutaneous transforaminal endoscopic discectomy (PTED) using tar⁃ get puncture and 2-stage procedures in treating lumbar disc hernia. Methods Patients present in our clinic from January 2014 to June 2014 with lumbar disc hernia who were treated with PTED were collected (n=36). Lower back and leg pain were evaluated by visual analog scale (VAS) while clinic outcome were assessed by Oswestry disability index (ODI) and modified Macnab criteria. Results All surgeries were carried out successfully. On average, operation time was（125±31）min, blood loss was（8.5±2.9）mL in each operation. The average length in hospital stay was（7.6±3.5）day. Compared with the preoper⁃ ative VAS scores，the postoperative and last follow-up scores for lower back and leg pain decreased significantly (P＜0.01). The ODI of pre-operation and last follow-up were (18.90 ± 7.78)% and (73.30 ± 18.21)% respectively with statistic differ⁃ ence. As to the modified Macnab criteria，the "excellent and good" ratio was 94.4%. One case present hyperalgesia in L4 der⁃ matome which recovered through conservative treatment. No complications such as permanent nerve root injury，cerebrospi⁃ nal fluid leakage，or infection were found during or after operations. All patients are in stable conditions during follow-up pe⁃ riod without recurrence. Conclusion PTED using target puncture and 2-stage procedures is an effective method with mini⁃ mal trauma, less bleeding, quick recovery, high security, short hospitalization time. what′s more, it can remove protruded disc and broken nucleus from the intervertebral space. It ensure efficacy and avoid recurrence.

Key words: intervertebral disk displacement, surgical procedures, minimally invasive, percutaneous transforaminal endoscopic discectomy (PTED)