Precise guidance, direct to the affected area, "minimally invasive" in the end! The first case of lumbar intervertebral disc herniation treated by posterior lumbar discectomy in East China

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South Korea Chinese medical studentsRecently, a minimally invasive outpatient patients to Changhai Hospital Professor Fu Qiang, according to

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South Korea Chinese medical students

Recently, a minimally invasive outpatient patients to Changhai Hospital Professor Fu Qiang, according to the typical symptoms, signs and imaging, Fu Qiang professor gave a clear diagnosis of lumbar disc herniation (L5/S1), and suggested the minimally invasive surgical treatment. Originally this is a common process of diagnosis and treatment, but the patient's special identity, so that both doctors and patients are faced with thorny problems. Originally, the patient is a senior from Hanyang University in South Korea, in the face of graduation must as soon as possible to return to Korea to complete their studies, while the summer remaining less than two weeks, or have to leave a year; in addition to a 20 something young man, do not want surgery too long scar, affect the appearance. For Professor Fu Qiang, minimally invasive surgery is also common to solve the pain of patients, but the recovery time for 3-4 weeks, obviously can not meet the needs of patients; and transforaminal endoscopic new by posterolateral approach can achieve a small wound and can be discharged for second days, but in the application of L5/S1 the huge segment of central type protruding is still not satisfactory. This is the number of children's parents to get rid of a number of internationally renowned minimally invasive spine in South Korea, have not been satisfied with the reasons for treatment programs. To know that South Korea is the first to carry out minimally invasive spine surgery in Asia, the largest amount of surgery, the highest international reputation of the country. The challenge is self-evident!

Doctor patient pain headache

Low back pain is one of the symptoms of lumbar disc herniation is common in clinic, its etiology, treatment is also not the same, do not have much experience of the doctor can not start, and even "doctor patient pain headache". Lumbar disc herniation is the most common cause of low back pain etiology. The disease is more common in young adults, patients suffering from pain, accompanied by cauda equina involvement can cause dysfunction, severe can cause paralysis. Have a great influence on the life and work of patients.

Surgical removal of the intervertebral disc should be considered when the nonoperative treatment is not effective or the symptoms are repeatedly affected. The traditional methods of lumbar discectomy, including posterior lumbar laminectomy, hemi laminectomy or total laminectomy, anterior extraperitoneal discectomy, are still widely used. However, the traditional posterior surgery after skin incision, stripping sacrospinalis, retraction exposure lamina bite in addition to part or total laminectomy, removal of the yellow ligament, removal of nucleus pulposus, both inside and outside the spinal hemostasis steps, traditional surgery fully exposed view, direct manipulation of the removal of nucleus pulposus, nerve root decompression fully, postoperative effect is affirmative the. But the traditional posterior open surgery in some cases of nerve root adhesion, lumbar instability, leading to long-term remission or not lumbocrural pain again lumbocrural pain. Moreover, the operation itself may cause complications such as trauma, infection, recurrence, long term bed rest and spinal instability. In addition, with the large number of traditional lumbar disc surgery, postoperative lumbar instability, nerve root adhesion has become the most common problem.

Therefore, minimally invasive surgery is becoming one of the most popular research directions in spine surgery.

Better effect and less trauma

In a sense, lumbar disc herniation means that there is a lumbar instability. Resection of the structure is too much, will lead to the occurrence of lumbar instability. Therefore, it is necessary to use minimally invasive techniques to reduce unnecessary loss of normal lumbar spine structure, to prevent instability after lumbar disc surgery is of great significance. At the same time, any operation means scar formation, which is more important to the nervous system. As little as possible to protect the nerve around the protection of tissue, will reduce postoperative recurrence and adhesion.

The United States, Germany and other developed countries have begun to use special endoscopic puncture directly through the nerve root hole into the spinal canal, observe the prominent position and compression of the nerve tissue, directly under the direct removal. Because the equipment technology content increases over the diameter of less than 7mm in the channel focused light source, camera, lavage, attract and operation equipment coexistence channel, make this technology under the same conditions is better than that of minimally invasive percutaneous lumbar discectomy and operation, increase the practicability and accuracy of minimally invasive techniques.

Professor Fu Qiang has been in a minimally invasive spine center in the United States had access to learning, have mastered the technology, including mirror transforaminal MED technology, Spotlight pipeline technology, Mast Quadrant and other minimally invasive retractor of the latest international development of minimally invasive surgery, after returning home and cured more than 200 patients, excellent surgery, get good word of mouth. This time, the student's parents are also multi inquire after admiring.

Bold innovation break the problem

However, any technology has its limitations. Although it is recognized as a minimally invasive technique for minimally invasive surgery, the application of the L5/S1 segment is controversial. Recognized by the posterolateral approach for surgery, often because patients with iliac crest high effect of surgical operation, the failure of the operation; in addition, the central type protruding cases, removing the disc decompression without damaging the nerve root and the dural sac is a difficulty.

Professor Fu Qiang through long time at home and abroad to learn the knowledge gained with their rich clinical experience, bold innovation, put forward through interlaminar approach for the Korean students of lumbar disc herniation combined with foraminal mirror technology (L5/S1). The operation will be through the X-ray machine positioning, find the lamina gap between adjacent vertebrae, minimally invasive drilling in the yellow ligament and soft tissue after the puncture, the lens accurately entered the spinal canal, the direct exposure of the dural sac and nerve root completely unaffected by the bony structure of the iliac crest, surgery can direct the central part of intervertebral disc disc, disc on the side of the central or even removed, to protect the nerve roots and dural sac more thoroughly. Surgical trauma will be reduced to a minimum of second days to discharge, should be able to meet the needs of children and parents. However, this type of surgery is only a small amount of international development, there are no special design of surgical instruments, narrow space, difficult to determine the location of the nerve root and separation of surgical difficulties. Based on the experience of more than 3000 cases of lumbar spine surgery, Professor Qiang has carefully designed the surgical procedure and scheme for the removal of the intervertebral disc by the combination of the interlaminar approach and the endoscopic discectomy. This will be the first time in East china.

Patient with excellent curative effect

Before the positive preparation, the operation was completed in the near future. The operation lasted about 1 hours or so, as was the case before the design, which was done by Professor Shen, who was able to complete all the surgical procedures in a smooth manner. Stay awake after anesthesia, Professor Fu Qiang re evaluated the condition, the symptoms of low back pain disappeared immediately after surgery, the operation was a success. More patients and their families are pleased that the incision is only 0.8cm, almost no scar. In addition, Professor Qiang also told them that the day after the patient's activities can be under the ground, two weeks after school can go to school, it is beyond their expectations. Second days after surgery, the patient was discharged. Before going, the patients and their families must pay and pay a strong Professor posed for pictures, and said that the legend will be told to the relatives and friends of South korea.

 

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