| 朱慧阳,叶斌,段伟,李沫,叶正旭*.术前三维影像测量结合激光导航器辅助穿刺行经椎间孔入路经皮内窥镜下椎间盘切除术[J].脊柱外科杂志,2019,17(1):11-17. |
术前三维影像测量结合激光导航器辅助穿刺行经椎间孔入路经皮内窥镜下椎间盘切除术  点此下载全文 (Fulltext) |
| 朱慧阳 叶斌 段伟 李沫 叶正旭* |
| 空军军医大学第一附属医院脊柱外科, 西安 710032 |
| 基金项目： |
| DOI：10.3969/j.issn.1672-2957.2019.01.003 |
| 摘要点击次数: 791 |
| 全文下载次数: 617 |
| 摘要： |
| 目的 探索术前三维影像测量结合自行研制的激光导航器辅助穿刺行经椎间孔入路经皮内窥镜下椎间盘切除术（PETD）的临床效果。方法 2016年3月-2017年8月，共57例腰椎椎间盘突出症（LDH）患者接受PETD治疗，32例患者采用传统穿刺方式行PETD（对照组）；25例患者采用激光导航器辅助穿刺行PETD（试验组）。术中记录穿刺次数、手术时间、透视次数及患者术中疼痛视觉模拟量表（VAS）评分，并进行比较。结果 试验组穿刺次数、透视次数、手术时间及术中腰痛VAS评分均明显低于对照组，差异有统计学意义（P<0.05）。2组术后VAS评分与术前相比均明显改善，差异有统计学意义（P<0.05）。结论 激光导航器结合三维影像测量辅助穿刺，能够有效减少PETD的穿刺次数、透视次数及手术时间，手术效果良好，可减少患者术中长期俯卧产生的不适感，降低医患人员辐射暴露剂量，间接降低PETD的学习曲线。 |
| 关键词：腰椎 椎间盘移位 内窥镜检查 椎间盘切除术,经皮 外科手术,微创性 计算机辅助设计 成像,三维 |
| Preoperative three-dimensional image measurement combined with laser navigator assisted puncture for percutaneous endoscopic transforaminal discectomy Fulltext |
| ZHU Hui-yang YE Bin DUAN Wei LI Mo YE Zheng-xu* |
| Department of Spinal Surgery, First Affiliated Hospital of Air Force Military Medical University, Xi'an 710032, Shaanxi, China |
| Fund Project: |
| Abstract: |
| Objective To explore the clinical effect of percutaneous endoscopic transforaminal discectomy(PETD) combined with preoperative three-dimensional image measurement and self-developed laser navigation device assisted puncture. Methods From March 2016 to August 2017, 57 patients with lumbar disc herniation(LDH) were treated with PETD. According to the fluoroscopy and clinical experience during the operation, 32 patients underwent "exploratory" puncture (control group); 25 patients underwent "targeted" puncture according to preoperative imaging examination and puncture angle simulated by software(experimental group). The punctures frequency, operation time, fluoroscopy frequency and visual analogue scale(VAS) score of the patients during the operation were recorded and compared during the operation. Results In the experimental group, the punctures frequency, operation time, fluoroscopy frequency and VAS score of the patients during the operation were significantly less than those in the control group, and the differences were statistically significant(P<0.05). The VAS scores of the 2 groups at post-operation were significantly less than those at pre-operation, and the differences were statistically significant(P<0.05). Conclusion The laser navigation device combined with three-dimensional image measurement assisted puncture can effectively reduce the puncture frequency, operation time and fluoroscopy frequency of PETD, with a good clinical effect, thereby reducing the discomfort caused by long-term prone posture during operation, radiation exposure dose of doctors and patients, and learning curve of PETD indirectly. |
| Keywords:Lumbar vertebrae Intervertebral disc displacement Endoscopy Diskectomy, percutaneous Surgical procedures, minimally invasive Computer-aided design Imaging, three-dimensional |
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