1、经椎体入路经皮内镜下颈椎间盘髓核摘除术的可经椎体入路经皮内镜下颈椎间盘髓核摘除术的可摘要：目的 探讨经椎体入路在经皮内镜下进行颈椎间盘髓核摘除神经减压的可行性。方法 2016 年 3 9 月,选取 4 具新鲜冰冻尸体标本进行前瞻性研究,男女各 2 具,年龄70 岁。术前 T 检查确定手术靶点和设计骨性通道,经 4、5、6、7 椎体入路手术各 1 具。于血管鞘和气管食管鞘之间进行椎体穿刺,置入工作外鞘于椎体内,镜下磨钻磨除骨质建立骨性通道,经皮内镜直视下去除突出的髓核及骨赘。记录手术时间、透视曝光数,术后 T 检查解剖术区相应组织结构。结果 4 具尸体均完成经椎体入路的经皮内镜下颈椎间盘髓核摘除
2、术操作,4 和 5 骨性通道方向为前上至后下,6 和 7 为前下至后上。手术时间分别为 92、73、65 和 60 in,平均 72.5 in;术中透视数24、 、19 和 18,平均.5。术后 T 检查证实骨性通道完整,椎体无骨折塌陷。结论 经椎体入路在经皮内镜下进行颈椎间盘髓核摘除脊髓与神经根减压是可行的,该手术方式值得临床进一步研究应用。Abstrat： bjetive T evaluate the feasibility f transrpreal perutaneus endspi ervial disety( TPED) in a aver study. ethds Fur sel
3、eted fresh ult aver speiens, -70 years ld, high-reslutin puterized tgraphy ( T ) data ere lleted befre perating fr transrpreal tunnel design. Depressin f levels ( fr 3/4 t 6/7 ) as used by transrpreal apprah in eah speien. A punture needle as vaned int the target vertebra beteen vasular sheath and t
4、raheesphagus sheath under flurspi guidane. A rking hannel ith beveled end as inserted int the target vertebra. The rest f trajetry as nstruted ith high-speed drill under endspi nitring. Depressin f dural and never rt uld be ell btained by visualized reving f the herniated dis fragent r stephyte. per
5、ating tie and flurspy frequeny during the surgery ere rerded. T exainatin as perfred after surgery. Results Surgeries ere aplished. The rientatin f transrpreal trajetry as fr anterir superir t psterir inferir in 4 and 5 vertebral bdy, the rientatin f transrpreal trajetry as fr anterir inferir t pste
6、rir superir in 6 and 7 vertebral bdy. The peratin tie as 92, 73, 65 and 60 in, ean 72. 5 in; the frequeny f flurspi heking as 24, , 19 and 18 ties during the perating, ean . 5 ties. Pstperative T sanning as perfred t nfir that the hle transrpreal tunnel as retained and the target vertebra asn t llap
7、sed. The iprtant anatial strutures near surgial area ere nt daaged. nlusins Transrpreal perutaneus endspi ervial disety is tehnially feasible fr ervial depressin, hih needs t be prven in future linial studies.作者：陈亮 肖福涛 楚磊 石磊 余柯晓 于庆帅 邓忠良Authr：hen Liang Xia Futa hu Lei Shi Lei Yu Kexia Yu Qingshuai Deng Zhngliang作者单位：重庆医科大学附属第二医院骨科, 重庆,0010关键词：椎间盘移位 椎间盘切除术,经皮 解剖学,局部 经椎体入路 颈椎Keyrds：Intervertebral dis displaeent Disety,perutaneus Anaty,reginal Transrpreal apprah ervial vertabrae基金项目：重庆市卫生局医学科研计划项目
