Double tractors swing microendoscopic discectomy technique for multi-segmental lumbar disc herniatio

張春霖(Zhang Chunlin，Dept Orthop Surg，1st Affil Hosp Zhengzhou Univ，Zhengzhou 450052)…∥Chin J Orthop.－2010，31(1).－44～49

Double tractors swing microendoscopic discectomy technique for multi-segmental lumbar disc herniatio

張春霖(Zhang Chunlin，Dept Orthop Surg，1st Affil Hosp Zhengzhou Univ，Zhengzhou 450052)…∥Chin J Orthop.－2010，31(1).－44～49

ObjectiveTo evaluate the effect of double tractors swing microendoscopic discectomy technique in multisegmental lumbar disc herniation.MethodsFrom December 2006 to November 2009，153 patients with multisegmental lumbar disc herniation were treated with double tractors swing microendoscopic discectomy.They included 85 cases of multi-segmental disc herniation，53 cases of degenerative canal stenosis and 15 cases of lumbar instability.Among them，2，3，4 and 5 fenestrations were performed in 105，33，13 and 2 cases respectively and interbody fusion was done with“quanhe”inflation cage and screws in 15 cases.The results were evaluated with Macnab scale.ResultsAll the 153 patients were followed from 3to 36 months，with an average of 16 months.The mean operative time was 45，61，83 and 110 min for 2，3，4 and 5 fenestrations respectively，with a mean blood loss of 150 mL.And it took extra 92 min to finish interbody fusion.Complications included dural sac tears in 1 case，canda equina slight lesion in 1，superficial incision infection in 1，the formation of deep venous thrombosis in 1，and revision for“quanhe”inflation cage in 1.The mean hospital stay was 10 days.Excellent results were obtained in 117 cases，good in 32 and fair in 4.One hundred and thirty-two patients returned to their work or normal activities in 3 weeks.One hundred and forty-nine cases were satisfied with the therapeutic effect.ConclusionThis technique can not only reach adjacent intervertebral space easily but also disperse pressure on the nerve root effectively.This technique can provide thorough decompression and good results.9 refs，4 figs.

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