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Discectomy of lumbar disc herniation treatment

Forced the removal of nucleus pulposus and nerve root canal while expanding, thus severely limited surgery, postoperative long-term outcome is not satisfactory, have little clinical application. Early 90s,[link widoczny dla zalogowanych], transforaminal lumbar intervertebral disc into the spinal canal mirror used in the treatment of lumbar disc herniation. Such mirrors can only remove the vertebral disc is easy to ask the soft chopped prominent nucleus pulposus on the bone hyperplasia, hyperplasia facet cohesive and free of nucleus pulposus prolapse is difficult to handle, and the foramen surgery on patients who puncture technical requirements for high intraoperative puncture failure occur. Percutaneous vertebral disc excision asked the optic nerve root and dural sac can not direct pressure situations, often incomplete decompression. Percutaneous discectomy under direct vision can not operate discectomy and instrumentation to be used interchangeably, prone to nerve root injury, hematoma and lumbar intervertebral disc go far to ask complications 4j. METRX is a traditional discectomy and minimally invasive endoscopic technology, endoscopic complete laminectomy, yellow ligament, the medial facet resection, nerve root canal expansion disc discectomy and other operations. It can ensure that the premise of the smallest wound, excision of bone lesions and thickening of the yellow ligament,[link widoczny dla zalogowanych], nerve root canal expansion, to the effect of surgical decompression. Intraoperative vertebral ask if they offer outstanding adhesion and nerve root compression parts heavier, nerve root can not move, do not force the stretch at this time should be along the biting surface of the nerve root and facet except the medial part of the lamina, the nerve root canal After adequate decompression, and then separating the nerve root retractor prominent nucleus pulposus removed. METRX discectomy for lumbar disc system and the traditional open surgery, compared with a small incision (only 1.6cm), tissue trauma, less bleeding, without extensive dissection of paraspinal muscles, only to bite a little addition to the lower edge of the lamina bone quality, maintaining the stability of the spine,[link widoczny dla zalogowanych], after a short time in bed, fast recovery, 1 ~ 4d can be discharged, not only greatly reduce the psychological burden on the patient's pain and also reduce the pressure of accompanying persons, but also save the hospital expenses. According to our clinical experience, that the surgical indications and traditional fenestration similar to a variety of pathological lumbar disc herniation were applied, mainly used: conservative treatment fails to single level lumbar disc herniation; nucleus dissolved surgery, percutaneous absorption invalid cut lumbar disc herniation; Central, next to the central, lateral lumbar disc herniation; more than a few types of concomitant ipsilateral spinal canal,[link widoczny dla zalogowanych], nerve root canal stenosis. Re-operation for recurrent lumbar disc herniation, frail elderly patients with lumbar disc herniation and spinal stenosis should merge all options open surgery. Another puncture site of inflammation and spinal surgery are locally contraindication for surgery. Only strictly indications, endoscopic technique with a skilled and local anatomy, the right guidance of postoperative rehabilitation in order to achieve good therapeutic effect. Endoscopic treatment of lumbar disc herniation both the total elimination of nerve root compression, trauma, quicker recovery, without destroying the stability of lumbar spine 5Ioj. The treatment of lumbar disc herniation ideal method.

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