个体化“三定式”导向器在椎间孔镜手术中的应用研究  

Application of the individualized"Three-set"guide in discectomy

作　　者：林煜倩 赵薇 王建琳 王玉娟 余青泠 饶利兵 李莉 Lin Yuqian;Zhao Wei;Wang Jianlin;Wang Yujuan;Yu Qinglin;Rao Libing;Li Li(Hunan University of Medicine,Huaihua 418000,Hunan Province,China)

机构地区：[1]湖南医药学院,湖南怀化418000

出　　处：《中国临床解剖学杂志》2023年第5期599-602,607,共5页Chinese Journal of Clinical Anatomy

基　　金：湖南省自然科学基金(2022JJ50292);怀化市数字解剖与3D打印临床转化研究重点实验室项目(2020R2201);湖南医药学院教学改革研究项目(2021JG39);湖南省普通高校数字解剖与3D打印技术临床转化应用创新创业教育中心;横向课题:个体化“三定式”导向器在椎间孔镜手术中的应用研究。

摘　　要：目的探讨个体化“三定式”导向器辅助椎间孔镜手术治疗腰椎间盘突出症的临床意义。方法根据纳入和排除标准,选取2021年12月~2022年11月腰椎间盘突出症患者16例,随机分为两组,对照组(n=8)采用传统手术方法;实验组(n=8)利用团队自主设计的个体化“三定式”导向器辅助椎间孔镜手术,术前采集患者CT数据导入软件进行个体化设计,模拟手术穿刺路径,拟定进针位置、进针角度、进针深度(即“三定”),术中将个体化“三定式”导向器置于体表,根据修正值调整穿刺角度和方向,实现精准穿刺。比较两组透视次数、穿刺时间、穿刺次数。结果实验组透视次数、穿刺时间、穿刺次数均少于对照组,具有统计学意义(P<0.01、P<0.01、P<0.05)。结论应用个体化“三定式”导向器辅助椎间孔镜手术治疗腰椎间盘突出症切实可行,效果良好。Objective To explore the clinical effect of individualized"three-set"guide assisted endoscopic lumbar discectomy in the treatment of lumbar disc herniation.Methods According to the inclusion and exclusion criteria,16 patients with lumbar disc herniation from December to November were selected and randomly divided into two groups.The control group(n=8)was treated with traditional methods.The experimental group(n=8)was assisted by the individualized"three-set"guide in intervertebral foramen surgery.The CT data of patients were collected and imported into the software before operation to conduct individualized design,simulate the surgical puncture path,and determine the needle insertion position,needle insertion angle and needle insertion depth(referred to as"three-set").The individualized"three-set"guider was placed on the body surface,and the puncture angle and direction were adjusted according to the correction value,and the accurate puncture was realized by the guider.The times of fluoroscopy,puncture timing and puncture frequency of the two groups were recorded and statistically analyzed.Results The times of fluoroscopy,puncture timing and puncture frequency of the experimental group were less than those of the control group,with statistical significance(P<0.01,P<0.01,P<0.05).Conclusions It is feasible and effective to use the individualized"three-set"guide to assist intervertebral foramen surgery in the treatment of lumbar disc herniation.

关 键 词：“三定式”导向器 个体化设计 椎间孔镜 腰椎间盘突出 

分 类 号：R681.53[医药卫生—骨科学]