可扩张通道下腰椎微创融合内固定术的手术配合

Nursing Care During Minimally Invasive Surgery of Lumbar Interbody Fusion and Internal Fixation Through Expanded Control Channel

目的:探讨QUADRANT可扩张通道下行后路腰椎管减压、椎间融合和经皮椎弓根螺钉固定,治疗腰椎退变性疾病的手术配合体会。方法:笔者参与了应用QUADRANT可扩张通道行后路腰椎管减压、椎间植骨加融合器置入、经皮椎弓根螺钉固定治疗12例手术患者,对手术配合体会进行总结。结果:12例患者手术经过顺利,无转为开放手术病例,无1例发生术中并发症,手术切口均一期愈合。结论:腰椎微创、腰椎间融合、经皮椎弓根螺钉固定,术前充分准备,熟练掌握术中配合,虽然手术时间稍长,所需手术器械较多,术中配合较复杂,但其对软织损伤小、术中出血少、术后功能恢复快。

Objective： To sum the experiences in nursing care during surgery of lumbar canal decompression,interbody fusion and percutaneous pedicle screw fixation through the posterior lumbar QUADRANT expanded channels for the treatment of degenerative lumbar disorders.Method： The author participated in 12 cases of surgical procedures accessed by QUADRANT expanded channel including posterior lumbar canal decompression,fusion cage implantation and percutaneous pedicle screw fixation.The experiences obtained in the nursing care during these surgeries were summarized.Result： All 12 cases turned out uneventful during the operation,none of them needed open surgery or had complication occurred.The incisions achieved primary healing in all cases.Conclusion： All these minimally invasive approaches,inter body fusion and percutaneous pedicle screw fixation needed thorough preoperative preparation and skilled nursing care during the surgery.Although the surgery took long time to complete,more surgical instruments and complicated nursing care needed during the operation,it is less traumatic to soft tissue,causes less hemorrhage and results in faster recovery in function after the surgery.