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  • 泰安市第一人民医院成功开展微创椎间孔镜技术

    本报讯,近日,泰安市第一人民医院骨二科在手术麻醉科和影像中心配合下,成功为一位解剖变异腰椎间盘突出症患者实施了微创椎间孔镜手术。患者术后第一天就能在腰围保护下站立行走,术后第三天顺利出院。

    近一个多月来,市民孙某因腰痛严重不敢坐立和行走,只有卧床时疼痛才会减轻,生活十分痛苦。虽然孙某多次治疗,但疼痛症状一直没有减轻。近日,孙某腰痛症状加重,并伴有左下肢放射疼痛,后在他人推荐下到泰安市第一人民医院骨二科就诊。针对孙某的症状,并结合辅助检查结果,骨二科主任鞠玉亮判定患者患有腰椎间盘突出症并腰椎管狭窄。“单纯的保守治疗只能暂时缓解疼痛麻木症状,如果不摘除突出靶点的髓核组织,患者腰腿痛和下肢麻木的症状就无法得到根治,所以患者多次多地保守治疗均未能完全解除病痛。”鞠玉亮介绍说。

    鞠玉亮表示,对于上述疾病,手术治疗才能达到根治目的。目前手术治疗方式大体分两种,一种是微创椎间孔镜手术治疗,通过一个不到1厘米的皮肤切口,摘除突出的髓核组织,创伤小,局麻更安全,患者术中体验感好,但有严格的适应症;第二种是开放手术治疗,相比微创手术,开放手术创伤大,需要剥离椎旁肌肉,处理椎板等骨组织,术后恢复时间长。最终,患者及其家属商议后决定进行微创椎间孔镜手术治疗。

    6

    据悉,鞠玉亮带领全科医生进行了病例讨论,最终确定采用“两步走”的治疗方案。第一步,为患者实施选择性低剂量低浓度脊神经根阻滞术,该技术是一种诊断性治疗术式,适合于解剖变异的脊柱疾病患者,目的是明确突出的椎间盘是否为责任间盘,从而为下一步治疗提供理论依据;第二步,找到责任间盘后实施微创椎间孔镜手术治疗。按照此治疗方案,在鞠玉亮指导下,管士伟成功为患者实施了手术。术后患者即感到疼痛麻木症状基本消失,术后第一天即可在腰围保护下下地站立行走,术后第三天即出院回家。

    鞠玉亮表示,椎间孔镜脊柱微创手术是骨科专业人员通过操作特殊设计的椎间孔镜、配套的脊柱微创手术器械、成像系统和双极射频动力磨钻系统共同组成的脊柱微创手术系统完成的手术。该手术通过椎间孔途径进入,内窥镜下直视操作,各相关解剖结构清楚地呈现于屏幕上,安全性高,创伤非常小,术后恢复快,一般患者术后1天即可下地活动。

    骨二科成功开展此项技术后,实现了腰椎间盘突出症保守治疗、微创手术治疗和开放手术治疗三阶梯治疗理念的提升,为不同类型的腰椎间盘突出症患者提供个体化的治疗方案选择,在保证治疗效果的同时,降低手术创伤,减少组织破坏,提高治疗安全性,缩短康复时间,降低住院费用,为患者带来微创治疗福音。

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