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目的探讨ＣＴ引导的经皮穿刺治疗腰椎间盘突出症的临床应用价值。方法在ＣＴ引导下对３２例腰椎间盘突出患者，利用ＣＴ提供的三维图像穿刺定位，并在三维控制下选择最佳穿刺平面和最佳穿刺途径，进行经皮穿刺椎间关节镜腰椎间盘摘除术。其中男１８例，女１４例。年龄１９～５９岁，平均４０．５岁。随访２～８个月，平均６个月。并与“Ｃ”型臂Ｘ线透视引导的手术进行比较。结果切取椎间盘组织量，Ｌ４，５间隙由平均２．３ｇ增加至４．１ｇ，Ｌ５Ｓ１间隙由平均２．１５ｇ增加至３．２５ｇ。手术优良率由８２．２％，提高至９０．６％。结论ＣＴ引导提高了手术准确性，利于最大程度的切取椎间盘组织，降低椎间盘内压力使突出的椎间盘还纳。
Objective To investigate the clinical value of CT guided percutaneous lumbar puncture in the treatment of lumbar disc herniation. Methods Thirty-two patients with lumbar disc herniation under CT guidance were instrumented by three-dimensional (3D) image puncture using CT and the best puncture plane and optimal puncture under three-dimensional control were performed for percutaneous intervertebral arthroscopy lumbar disc herniation . There were 18 males and 14 females. Ages 19 to 59 years old, average 40.5 years old. Follow-up 2 to 8 months, an average of 6 months. And compared with the “C” type of arm-guided X-ray surgery. Results The amount of intervertebral disk was cut, the gap of L4,5 increased from 2.3g to 4.1g on average, and the gap of L5S1 increased from 2.15g to 3.25g on average. The rate of excellent operation improved from 82.2% to 90.6%. Conclusion CT guidance improves the accuracy of surgery, which is conducive to the maximum degree of intervertebral disc tissue removal, reduce the pressure in the intervertebral disc so that the prominent disc also satisfied.