Indications And Advantages Of Discoscopic Surgery
A minimally invasive surgical method of intervertebral disc endoscopy, that is, a 1.6cm skin incision is made next to the spinous process, and the lumbar intervertebral disc nucleus pulposus is performed under the monitoring of the working channel through the endoscope. Its working principle is to transmit the light beam to the front end of the endoscope objective lens through the optical fiber to illuminate the observed object, and then rely on the imaging and magnification of the lens to obtain a clear image, thereby observing the deep microscopic lesions.
Indications of intervertebral disc surgery
Discoscopy is mainly suitable for single-segment lateral lumbar disc herniation, but also for some lumbar disc herniation with calcification or lateral recess stenosis. It is not suitable for lumbar disc herniation with lumbar instability or central lumbar spinal stenosis. disease.
(1) Lumbar intervertebral disc herniation mainly caused by radicular pain;
(2) Extremely lateral lumbar disc herniation;
(3) Recurrence on the contralateral side of the original segment after surgery;
(4) Single-segment lateral recess stenosis and/or nerve root canal stenosis.
Compared with open surgery, disc mirror has the following advantages:
(1) The protruding nucleus pulposus tissue is directly removed under the microscope, and the effect is definite.
(2) The paravertebral muscles are not extensively stripped, the damage is small, the bleeding is less, and the incidence of low back pain after surgery is low.
(3) The surgical operation conforms to the habits of spine surgeons and is easy to master.
(4) Decompression of lateral recess or root canal can be performed at the same time.
(5) It is safe and reliable to operate the dural sac and nerve roots under the monitoring of the monitor.
(6) Fast recovery. You can get out of bed on the first day after surgery, which relieves the patient's worries about difficulty in urinating and defecating in bed, and the hospital stay is short, which reduces the economic burden of the patient.
However, the limitations of discoscopic surgery are also obvious:
(1) The surgical field of view is small, and the operation is performed in the working channel with an inner diameter of 1.5cm. If the working channel needs to be moved, it will cause soft tissue herniation.
(2) A small amount of epidural hemorrhage fills the surgical field and affects the operation.
(3) Many patients have been treated with sacral canal therapy, root canal injection therapy and collagenase therapy. There are often nerve roots and dural sac adhesions. It is difficult to peel off under the microscope, which can easily lead to dural sac tear and cerebrospinal fluid leakage.
(4) The facet joints and lamina are hypertrophy, and it is difficult to bite them with micro-pistol forceps, but they are not equipped with micro osteotome.
(5) The surgeon needs time and case accumulation process from unfamiliar to skilled, especially hand-eye coordination. Beginners take a long time to operate and are prone to complications such as nerve root injury.
The intervertebral disc surgery system is composed of an endoscope camera system, a cold light source, an imaging system (medical monitor) and other microsurgical instruments. This system perfectly combines advanced technology and clinical practice to provide patients with a kind of injury Low, short course of treatment, safe and reliable treatment method. It can remove the protruding nucleus pulposus tissue, the hypertrophic ligamentum flavum and the hyperplastic cohesive articular process and other nerve-causing factors, so as to obtain the curative effect of radical treatment.
