摘要
[目的]为椎间孔镜(transforaminal endoscopic spine system,TESSYS^(TM)技术)手术的实施提供参考影像测量数据。[方法]回顾性分析2014年7月—2021年9月78例接受椎间孔镜手术治疗的脱垂型腰椎间盘突出症患者的临床资料。术前影像测量穿刺的椎间孔宽度、安全水平距离、水平角度和头倾角度,并在术中验证是否达到预期穿刺目标靶点并评估手术有效率和安全性。[结果]不同脱垂程度同节段椎间孔宽度差异均无统计学意义(P>0.05),相同脱垂程度,不同节段间椎间孔宽度差异均有统计学意义(P<0.05):椎间孔宽度:L_(3/4)>L_(4/5)>L_(5)S_(1)。安全水平角、穿刺进针点距离棘突的体表水平距离在不同脱垂程度同节段及相同脱垂程度不同节段间的差异均无统计学意义(P>0.05)。采用上述影像数据为引导,所有患者术中均达到靶向穿刺并顺利完成手术。[结论]术前影像三维测量有利于制定个性化穿刺规划,指导术中安全准确地穿刺。
[Objective]To provide imaging data for accurate puncture in percutaneous transforaminal endoscopic discectomy(PTED,TESSYS^(TM)technique)for prolapsed lumbar disc herniation(LDH).[Methods]A total of 78 patients who were undergoing PTED for prolapsed LDH were enrolled in this study from July 2014 to September 2021.Preoperative images were used to measure the width of intervertebral foramen,safe horizontal distance,horizontal angle and head tilt angle during puncture.In addition,the imaging data were used to guide the puncture in real operation,and verified by the precise,efficiency and safety of the operation based on whether the expected puncture target was reached.[Results]There was no significant difference in the width of intervertebral foramen among different prolapse extents(P>0.05),whereas which were of statistically significant difference among different levels in the same prolapse extent(P<0.05).The foraminal width was significantly ranked up-down as L_(3/4)>L_(4/5)>L_(5)S_(1).However,there were no significant differences in the safe horizontal angle,the body surface distance between puncture point and spinous process in the same segment with different prolapse extents and in different segments with the same prolapse extents(P>0.05).Applying the abovementioned imaging data as guide,all the patients achieved accurate targeted puncture point and had operation completed successfully.[Conclusion]The preoperative image measurement data are beneficial to develop personalized puncture planning and guide safe and accurate puncture during surgery.
作者
麻凤玉
李宜照
杨涛
王叶新
梁啸
孟纯阳
MA Feng-yu;LI Yi-zhao;YANG Tao;WANG Ye-xin;LIANG Xiao;MENG Chun-yang(People's Hospital of Rizhao,Rizhao 276800,China;School of Clinical Medicine,Jining Medical University,Jining 272000,China;Afiliated Hospital of JiningMedical University,Jining 272000,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2022年第23期2197-2200,共4页
Orthopedic Journal of China
基金
日照市自然科学基金青年基金项目(编号:RZ2021ZR51)
济宁医学院教师科研扶持基金项目(编号:JYFC2018FKJ167)。
