脊柱内镜在腰椎椎间孔成形技术中的临床应用  

Clinical Application of Spinal Endoscopy in Lumbar Intervertebral Foramenoplasty

作　　者：迟文鑫 张存鑫 吕超亮[2] 张科峰[2] CHI Wen-xin;ZHANG Cun-xin;LYU Chao-liang;ZHANG Ke-feng(School of Clinical Medicine,Jining Medical University,Jining 272000,Shandong,China;Spinal Surgery Department of Jining First People's Hospital,Jining 272000,Shandong,China)

机构地区：[1]济宁医学院临床医学院,山东济宁272000 [2]济宁市第一人民医院脊柱外科,山东济宁272000

出　　处：《医学信息》2024年第3期169-175,共7页Journal of Medical Information

基　　金：山东省医药卫生科技发展计划项目(编号:202104070383);济宁市重点研发计划项目(编号:2020JKNS008)。

摘　　要：随着微创概念在临床实践中的发展及器械设备的不断演进,脊柱内镜技术已由盲视技术更迭为可视技术,其以切口小、恢复快、住院时间短以及与开放手术相当的临床疗效而获得广泛认可,脊柱内镜的适应症也逐渐拓宽,已普遍应用于多种腰椎疾病的治疗中。椎间孔成形是侧路脊柱内镜技术的关键步骤,其通过靶点穿刺建立工作通道,可视环境下利用多级工作套管按需多次成形,实现了对受压神经根的充分减压,椎间孔的成形质量高低直接决定着手术疗效及并发症的发生概率,影响患者预后。本文通过查阅近年该领域相关文献,对脊柱内镜在腰椎椎间孔成形技术中应用的发展概况、椎间孔解剖、成形器械变迁、应用现状及该技术的优势及局限性等方面展开综述,以指导临床治疗。With the development of minimally invasive concepts in clinical practice and the continuous evolution of instruments and equipment,spinal endoscopic techniques have been replaced by visual techniques from blind-vision techniques,which have gained more and more recognition due to their small incisions,fast recovery,short hospitalization time and clinical efficacy comparable to that of open surgeries,and the indications for which are gradually broadened that widely used in the treatment of various lumbar spine diseases.Interforaminal foramenoplasty is a key step in lateral spinal endoscopic technique,which establishes a working channel through target puncture,and utilizes multilevel working trocars to form the foramenoplasty as many times as necessary under visualization,thus realizing adequate decompression of the compressed nerve root.The quality of foramenoplasty directly determines the efficacy of the surgery and the probability of complications,which affects the prognosis of the patients.In this article,we review the development of spinal endoscopy in lumbar intervertebral foramenoplasty,the development of the application of spinal endoscopy in lumbar intervertebral foramenoplasty,intervertebral foramen anatomy,the change of forming equipment,the application status,the advantages and limitations of this technology are reviewed to guide clinical treatment.

关 键 词：脊柱内镜 经皮椎间孔镜 椎间孔成形 微创 

分 类 号：R687.3[医药卫生—骨科学]