单纯超声引导下经皮椎间孔镜腰椎间盘切除术一例

Ultrasound guided percutaneous transforaminal endoscopic lumbar discectomy with no radiation: a case report

目的探讨单纯超声引导下经皮椎间孔镜腰椎间盘切除术的可行性。方法以腰椎横突为标志物,超声在纵切面上定位腰椎节段,在横切面上以横突头侧的高回声区作为穿刺和置管的靶点进行实时引导。结果术后患者症状明显减轻。术后MRI显示,椎间盘突出部髓核的实体组织已完全切除,神经根已完全松解,无并发症。结论本文是国际首例超声引导下的零辐射经皮椎间孔镜腰椎间盘切除术报道(医疗卫生科技查新报告2019023号;解放军总医院医疗卫生科技查新站;查新时间2019年3月18日)。超声引导将明显降低,甚至有望完全取代椎间孔镜手术中穿刺置管过程的X线辐射,具有重要临床价值。

Objective To explore the possibility of ultrasound guided percutaneous transforaminal endoscopic lumbar discectomy(PELD)with no radiation.Methods The lumbar transverse processes were used as the markers to locate the target level on longitudinal section.A hyperechoic zone on transverse section of lumbar ultrasound was used as the marker to puncture and cannulation of PELD,and the operation was completed.Results After operation,the symptoms were relieved obviously.Postoperative MRI showed that the solid tissue of nucleus pulposus in the herniated disc had been completely removed,and the nerve root had been completely released without complications.Conclusions This is the first case of zero radiation PELD guided by ultrasound in the world(Report of Novelty Search of Medical and Health Science and Technology No.2019023;Novelty Search Station of Medical and Health Science and Technology,General Hospital of PLA;Novelty Search Time,March 18 th,2019).It has important value to further reduce the radiation dose of PELD during puncture and intubation under the guidance of ultrasound.