刘德隆 田世杰 王进军 苏庆军 杨煦 郭玉珠 曹宝信 刘德隆、田世杰、王进军、苏庆军、杨煦、郭玉珠 100020 首都医科大学附属北京红十字朝阳医院骨科，曹宝信 放射科 中华骨科杂志 1999 0 19 2


    关键词：腰椎；椎间盘；压力 期刊 zhgkzz 0 脊柱脊髓疾患 fur -->


    

【摘要】目的 探讨CT引导的经皮穿刺治疗腰椎间盘突出症的临床应用价值。方法 在CT引导下对32例腰椎间盘突出患者，利用CT提供的三维图像穿刺定位，并在三维控制下选择最佳穿刺平面和最佳穿刺途径，进行经皮穿刺椎间关节镜腰椎间盘摘除术。其中男18例，女14例。年龄19～59岁，平均40.5岁。随访2～8个月，平均6个月。并与“C”型臂X线透视引导的手术进行比较。结果 切取椎间盘组织量，L_4，5 间隙由平均2.3g增加至4.1g，L₅ S₁ 间隙由平均2.15g增加至3.25g。手术优良率由82.2%，提高至90.6%。结论 CT引导提高了手术准确性，利于最大程度的切取椎间盘组织，降低椎间盘内压力，使突出的椎间盘还纳。

    Percutaneous CT Guided Lumbar Discectomy

LIU Delong, TIAN Shijie,WANG Jinjun,et al.

    Department of Orthopaedic Surgery, Beijing Red Cross Chaoyang Hospital Affiliated to the Capital University of Medical Sciences, Beijing 100020

【 Abstract 】Objctive To evaluate the clinical significance of percutaneous microscopic discectomy guided by computed tomography. Methods 32 patients were included in this study. There were 18 males and 14 females. The mean age was 40.5 years(range,19- 59 years). The duration of follow up ranged 2 to 8 months, with an average of 6 months. Position-setting and puncture were introduced under three- dimensional CT, and compared with those under C-arm- X-ray. Result The quantity of removed tissue from the disc was increased from 2.3 g to 4.1 g at L_{4 - 5} space,and from 2.15 g to 3.25 g at L₅ - S₁ space. The excellent and good rate was 90.6% . Conclusion The CT guided percutaneous lumbar discectomy make the puncture more precise, and the disc tissue could be taken off fully. As a result,entradiscal pressure was reduced and protrution of the disc was eliminated.

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