经皮完全内镜下脊柱手术技术的发展与现状

Development and present status of percutaneous full-endoscopic spine surgery

现代经皮内镜下脊柱手术技术的发展是建立在Yeung发明的YESS （ yeung endoscopic spine system ）脊柱内镜系统及YESS技术基础之上的。Ruetten，Hoogland等在YESS脊柱内镜系统基础上进行改进，并提出完全内镜技术（ full-endoscopic technique ）及TESSYS （ transforaminal endoscopic surgical system ）等概念。但这些脊柱内镜系统都是使用带工作通道的硬杆状内镜在持续生理盐水灌洗下进行的微创脊柱手术，只是手术技术上不断改进以适应更复杂的病例，所以都可以称为完全内镜下手术技术。目前主要用于颈、腰椎间盘突出症、颈椎管狭窄症、腰椎管狭窄症及慢性腰痛等疾病的治疗。

With the improvement of the instrument and development of the technique, the same curative effects can be achieved in modern percutaneous endoscopic spine surgery as in traditional open surgery in the treatment of lumbar disc herniation. And the occurrence rate of complications is obviously reduced. The percutaneous endoscopic technique can be performed via the interlaminar approach and the transforaminal approach. Lumbar spinal stenosis and joint bone cyst are effectively treated with percutaneous endoscopic spinal canal decompression. Good curative results will be obtained in percutaneous endoscopic cervical discectomy and cervical intervertebral foramen dissection via anterior and posterior approaches for cervical disc herniation, cervical foraminal stenosis and so on. With unique advantages and higher treatment effectiveness, the percutaneous endoscopic technique is also effective in the treatment of chronic cervical and lumbar pain.