超声在脊柱外科应用的研究进展  

Application and progress of ultrasound in spine surgery

作　　者：杨凯琪 顾广飞[1] 贺石生[1] Yang Kaiqi;Gu Guangfei;He Shisheng(Department of Orthopaedics,Spine Surgery,the Tenth People's Hospital of Tongji University,Shanghai 200072,China)

机构地区：[1]同济大学附属第十人民医院脊柱外科,上海200072

出　　处：《中华骨科杂志》2024年第12期843-850,共8页Chinese Journal of Orthopaedics

基　　金：国家自然基金项目(82001927);2024年院级教育研究项目(2024-A-2)。

摘　　要：超声因具有无辐射、便携、价廉等优势而在普外科、妇产科等领域得到了广泛应用。但超声骨显像受限,因此在脊柱外科的应用并不多见。近年来超声技术与设备的发展拓宽了其在脊柱外科的应用场景。在诊断方面,肌骨超声能够清晰显示肌肉、肌腱、关节等组织的解剖结构,对脊柱疾病早期诊断具有重要意义;治疗方面,超声引导下脊柱源性疼痛介入治疗已较为成熟,包括选择性神经根阻滞、关节突关节阻滞等,显示出较高的准确率、安全性及疗效。超声辅助脊柱内镜手术置管应用的增加可减少术者及患者的辐射暴露;基于超声对椎弓根螺钉钉道完整性及钉道内壁与皮质骨距离的评估,研究者对其在脊柱椎弓根螺钉置入手术中的应用进行了进一步探索,开发了新型椎弓根探路器等,但目前对超声设备参数设置仍存在争议。此外,术中超声在脊柱肿瘤手术中可辅助定位肿瘤、评估切除范围以及在减压手术中评估减压效果和脊髓灌注状况。尽管超声在脊柱外科的应用前景广阔,但仍存在一些问题,如图像清晰度不高、分辨精度偏低、骨显像受限等。超声技术在脊柱外科的应用已展现出巨大的发展潜力,随着技术的进步和医生技能的提升,未来将在脊柱外科领域发挥更大的作用。Ultrasound has no radiation,portable,low price advantages,has been widely applied in the areas of general surgery,gynecology and obstetrics,however,there are some restrictions on ultrasound in bone imaging,its application in spine surgery are rare.In recent years,the development of technology and equipment has broadened the application scenarios of ultrasound in spine surgery.In terms of diagnosis,musculoskeletal ultrasound can clearly show the anatomical structure of muscles,tendons,joints and other tissues,which is of great significance for the early diagnosis of spinal diseases.In terms of treatment,ultrasound guided interventional therapy for spinal pain has been relatively mature,including selective nerve root block and facet joint block,which has shown high accuracy,safety and efficacy.In recent years,the application of ultrasound-assisted endoscopic spinal surgery has increased,which can reduce the radiation exposure faced by the operators and patients.Based on the evaluation of the integrity of the pedicle screw track and the distance between the inner wall of the screw track and the cortical bone by ultrasound,researchers have further explored its application in spinal pedicle screw placement,and developed new pedicle pathfinder.However,there are still controversies about the parameter settings of ultrasound equipment.In addition,intraoperative ultrasound can assist in locating tumors,assessing the extent of resection,and evaluating the effect of decompression and spinal cord perfusion during spinal tumor surgery.Although ultrasound has a broad application prospect in spine surgery,there are still some problems,such as low image clarity,low resolution accuracy,and limited bone imaging.In conclusion,the application of ultrasonic technology in spine surgery has shown great potential,with the progress of technology and the improvement of the doctor skills,the future will play a more important role in the field of spine surgery.

关 键 词：超声检查 脊椎穿刺 外科手术 计算机辅助 脊柱疾病 

分 类 号：R445.1[医药卫生—影像医学与核医学] R687.3[医药卫生—诊断学]