[摘要] 目的 探讨超声刀应用于后路脊柱显微内窥镜椎间盘摘除术(Microendoscopic Discectomy MED)治疗腰椎间盘突出症中的优势与疗效。方法 我院自2005年1月~11月将根据患者症状、体征、体查、CT和或MRI确诊的腰椎间盘突出症患者97例随机分为两组，超声刀+MED组45例，采用超声刀处理椎板下缘等骨性结构；而常规MED手术组52例采用枪钳或电动磨钻处理。 结果 超声刀+MED组与常规MED组平均手术时间分别为42min和75min，平均术中失血量分别为29ml和61ml，平均术后引流量分别为13ml和29ml，差异均有显著性(P<0.05)；两组所有病例获得13月(6～17月)随访，按Macnnab标准，优良率分别为95.6%和92.3%,差异无显著性(P>0.05)。 结论 超声刀切割骨骼的同时不损伤软组织，且有同步止血功能，操作安全方便，能缩短MED手术时间，不失为脊柱手术一种理想的辅助工具。

    [关键词] 超声刀；内窥镜；腰椎间盘突出症；手术

    Application of ultrasonic cutter in treatment of Lumbar Disc Herniation by Microendoscopic Discectomy

    Zhang Chaoyue，Wu Jiawen ，Wu Song，et al. Department of Orthopaedics,the Third XiangYa Hospital of Central South University

    [Abstract] Objective To explore the advantages and effects of ultrasonic cutter appllied in the process of treating Lumbar Disc Herniation(LDH) by Microendoscopic Discectomy(MED). Methods Ninety-two cases of LDH were diagnosed by symptoms, signs, physical examination, CT scanning and/or MRI in the period from January to November，2005.All the cases were divided randomly into two groups. Laminas of forty-five cases were cut by Ultrasonic cutter(group one),and laminas of other fifty-two cases were disposed by rongeur and reamer(group two). Results The average time of operation was 42min and 75min respectively in group one and group two, the average volume of intra-operative blood loss was 29ml and 61ml respectively, the average volume of postoperative drainage was 13ml and 29ml respectively.Compared with group two,the operative time,the volume of intra-operative blood loss and the volume postoperative drainage of group one were lower significantly(P<0.05).All the cases of two groups were followed- up for 13 months (6～17months). The outcome was assessed by the criteria of Macnnab,95.6% and 92.3% excellent and good results were obtained in two groups respectively,which was not significantly different(P>0.05). Conclusion Ultrasonic cutter is a good auxiliary apparatus for spinal operation.It cuts the bone without bleeding and soft tissue injuries.It can be used in MED as a safe and convenient method. ......