内镜下椎间盘切除术
内镜下椎间盘切除术是一种微创手术，通过小切口置入内镜取出压迫神经根的突出椎间盘碎片。
最后更新: 2026-06-06
Definition
Endoscopic discectomy is the removal of herniated disc material through a thin endoscopic system. The procedure is performed under imaging guidance through a millimetric corridor; the surgeon visualizes the working field at high magnification with an endoscope that carries a camera and light source. Several approaches, such as transforaminal and interlaminar, have been described.
Indications
The technique is considered in selected patients with radicular pain from a disc herniation demonstrated on imaging and concordant with clinical findings, who have not responded to adequate conservative treatment. Not every type of herniation or level is suitable; suitability depends on the location and size of the herniation and the patient's anatomy.
Procedure
The procedure is usually performed under local or general anesthesia in the prone position. Under fluoroscopy or navigation, a thin cannula is placed to the target disc and the endoscope is advanced through it. The disc fragment compressing the nerve root is removed with specialized instruments. Substantial muscle preservation and a small skin incision define its minimally invasive nature.
Advantages and Limitations
Reported potential advantages include a smaller incision, less soft-tissue disruption and early mobilization in many patients. However, the technique has a significant learning curve and is not appropriate for every case; open or microsurgical techniques may be preferred in marked canal stenosis, significant instability or some complex herniations. Outcomes depend on patient selection.
Recovery and Risks
Recovery time varies by patient and procedure. As with all spine surgery, possible risks include infection, nerve injury, dural tear and recurrence. No outcome is guaranteed; the decision is made individually by considering the patient's clinical status together with imaging findings.
参考文献
- Gadjradj PS, et al. Full endoscopic versus open discectomy for sciatica: randomized controlled trial. BMJ. 2022.
- Ruetten S, et al. Full-endoscopic interlaminar and transforaminal lumbar discectomy. Spine. 2008.
- StatPearls — Endoscopic Discectomy. NCBI Bookshelf.
本文仅供一般参考，不能替代医疗检查。诊断与治疗决策因人而异。