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《China Journal of Endoscopy》 2001-06
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THE EXPLORATION OF SURGICAL CRITERIA OF LDH WITH MED

Zhang Chaoyue, Zhan Rensheng, et al. Department of Orthopaedics,The Third Xiang Ya Hospital of Central South University,Hunan Changsha 410013  
Objective:To explore the surgical criteria of Lumbar Disc Herniation(LDH) with Microendoscopic Discectomy (MED).Methods:By reviewing and analysizing the clinical materials of 208 patients(265 intervertebral discs)of LDH with MED.Results:All cases were followed up averagely 8 months.142 cases were evaluated as excellent,52 as good,14 as fair according to the Macnnab scale.Conclusions:The MED is a minimally invasive modern technique.To ensure the accuracy and safety of operation,the paper provides the following surgical criteria.First,location the endoscopic view should include the inferior margin of the upper lamina and the medial edge of the superior facet.Second,expousure of spinal canal.Selecting the triangular working zone between the inferior margin of the upper lamina and the medial edge of the superior facet and cuting though the ligamentum flarum as a safety path to operate.Third,removing the herniatied nucleus pulposus,making a through removing of the herniation in spinal canal and eliminating the nucleus in disc space according to the different ages.Fouth,enlargeing the nerve root canal.No compression in nerve root,the range of movement of nerve root is about 5 mm,the orifice can contain the right-angle explorer.
【CateGory Index】: R681.53
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