经皮椎间孔镜技术在腰椎病变中的应用和进展

Abstract

经皮椎间孔镜技术属于微创技术，具有创伤小、出血少、术后恢复快、术后并发症少、对脊柱稳定性影响小等优点。最初用来治疗的疾病为腰椎间盘突出症(Lumbar Disc Herniation, LDH)，即经皮椎间孔镜腰椎间盘切除术(Percutaneous Endoscopic Lumbar Discectomy, PELD)。腰椎间盘突出症是骨伤科的常见病、多发病，大部分通过保守治疗可以达到临床治愈，但保守治疗无效者需要手术治疗。传统手术治疗该病创伤大、出血多、术后恢复慢，随着微创技术的发展，经皮椎间孔镜椎间盘切除术越来越受到脊柱外科医生的青睐。此技术的应用范围也从腰椎间盘突出症扩展到腰椎不稳、椎间盘源性腰痛、腰椎管狭窄等疾病。本文将就此技术的发展概况、麻醉方法、运用范围与临床疗效作一综述。 Percutaneous Endoscopic Lumbar Discectomy (PELD) technique belongs to minimally invasive technique with the advantages of minimal trauma, less bleeding, rapid postoperative recovery, fewer complications and little affection on the spine stability. It is originally used to treat lumbar discherniation, namely percutaneous endoscopic lumbar discectomy. Lumbardisc herniation is a common disease and most of them can be treated through conservative treatment to achieve clinical cure results. But if the conservative treatment is ineffective, the patients require operative treatment. However, traditional surgical treatment has the features of large trauma, more bleeding and slow postoperative recovery. With the development of minimally invasive techniques, spine surgeons pay much attention to Percutaneous Endoscopic Lumbar Discectomy (PELD) technique. Furthermore, the indications of this technique also extend stolumbar spine instability, discogenic low back pain, lumbar spinal stenosis and other diseases. This paper will summarize the development, anesthesia, indications and clinical efficacy of this technique.