椎间孔镜技术安全性的解剖学研究  

Anatomic assessment of safety for endoscopic lumbar discectomy:acadaver study

作　　者：王作伟[1] 陈赞[1] 吴浩[1] 王兴文[1] 王凯 段婉茹[1] 关健 菅凤增[1] WANG Zuo-wei;CHEN Zan;WU Hao;WANG Xing-wen;WANG Kai;DUAN Wan-ru;GUAN Jian;JIAN Feng-zeng(Department of Neurosurgery/Neurospine Center/China International Neuroscience Institute,Xuanwu Hospital,Capital Medical University,Beijing 100530,China)

机构地区：[1]首都医科大学宣武医院神经外科/中国国际神经科学研究所/神经脊柱中心,北京100053

出　　处：《中国临床神经外科杂志》2020年第7期451-453,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的通过尸体标本解剖学研究,探讨椎间孔镜技术的安全性以及对脊柱稳定性的影响。方法选取6具脊柱标本的双侧L1~S1共60个椎间孔,建立椎间孔镜工作通道,观察通道建立、神经根和硬膜囊损伤情况,测量关节突关节切除范围。结果成功建立60个工作通道,其中1处(1.7%)发生硬膜囊损伤;骨钻距离神经根最短距离在0~5.8 mm,平均(3.2±1.1)mm;27处行椎间孔成形标本中,22处(81.5%)未破坏关节突关节,只切除部分下位椎体的上关节突,5处(18.5%)切除部分关节突关节,切除范围为整个关节突的7%~18%。结论椎间孔镜技术安全可靠,对脊柱稳定性无明显影响,但仍需警惕损伤神经情况发生。Objective To evaluate the safety of transforaminal endoscopic discectomy and and its impact on spinal stability by cadaver study.Methods Sixty intervertebral foramens(L1-S1)on both sides of 6 spinal specimens were selected.Broad easy immediate surgery technique was used to establish the working channel.The nerve root and dural sac injury,and the extent of facet joint resection were observed.Results Sixty endoscopic working channels were successfully established.Dural sac injury occurred in 1 channel(1.7%).There was no nerve root injury.The shortest distance between bone drill and exiting nerve root ranged from 0 to 5.8 mm.Of 27 channels receiving superior articular process removal,22 facet joints(81.5%)were intact and 5(18.5%)were removed partial facet joint with a rresection range of 7%~18%.Conclusions Percutaneous transforaminal endoscopic discectomy is a safe and reliable operative technique,and there is no obvious influence on the stability of the spine.However,it is still necessary to avoid the nerve injury caused by the excessive deviation of the working channel to the dorsal side.

关 键 词：腰椎疾病 椎间孔镜技术 安全性 解剖学 

分 类 号：R681.57[医药卫生—骨科学] R651[医药卫生—外科学]