Joimax椎間孔鏡技術(shù)ppt課件

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椎間盤造影 椎間孔成型 碎片摘除,減壓 髓核摘除 纖維環(huán)成型,Joimax椎間孔鏡技術(shù),1,Joimax的椎間孔鏡技術(shù),,椎間盤造影 椎間孔成型 碎片摘除 減壓 髓核成型 纖維環(huán)成型 全脊柱手術(shù),由外向內(nèi)的技術(shù) 適應(yīng)癥廣 創(chuàng)傷更小 學(xué)習(xí)曲線長,多種衍生技術(shù) 椎管狹窄 錐體固定,2,Joimax椎間孔鏡技術(shù)原理,安全三角區(qū),3,手術(shù)入路,,4,Joimax椎間孔鏡技術(shù),,5,第一步：手術(shù)前評估,,6,第二步：確定體位,,Joimax專利的脊柱手術(shù)專用床,7,第三步：確定進(jìn)針路線,,8,C型臂定位,9,第四步：椎間盤顯影,,,10,椎間盤顯影,11,染色的椎間盤,,12,第五步：放置導(dǎo)絲、導(dǎo)桿、導(dǎo)管,,13,放置導(dǎo)絲、導(dǎo)桿、導(dǎo)管,14,,,15,2018/8/2,16,,Access Details 2,first cannulated dilator placed over guide wire,first guiding tube placed over dilator,16,2018/8/2,17,,17,L5-S1專用導(dǎo)桿,,,18,第六步：用環(huán)鉆擴(kuò)孔,綠色：安全，直徑5.0mm。 黃色：注意，直徑6.5mm。 紅色：警惕，直徑7.5mm。,Joimax專利擴(kuò)椎間孔用環(huán)鉆,19,環(huán)鉆應(yīng)該防置的正確位置,環(huán)鉆尖端不能超過脊突中間線,20,用環(huán)鉆去除部分小關(guān)節(jié)突,,21,獨(dú)特的L5-S1水平擴(kuò)孔,Joimax特殊設(shè)計的導(dǎo)桿防止損傷,22,獨(dú)特的L5-S1水平擴(kuò)孔,,23,第七步：放置工作套管,,24,第八步：放置椎間孔鏡,,25,椎間孔鏡所見,鏡下看到突出髓核碎片,鏡下看到突出髓核碎片和硬膜囊,鏡下看到突出髓核碎片和神經(jīng)根,鏡下看到突出髓核碎片和小關(guān)節(jié)囊,26,髓核碎片壓迫神經(jīng),,27,第九步：摘除髓核碎片,,28,2018/8/2,29,,Transforaminal endoscopic access,29,8/2/2018,30,,30,摘除髓核碎片,31,手術(shù)后神經(jīng)解壓,手術(shù)后壓迫解除，神經(jīng)清晰可見,手術(shù)前髓核碎片壓迫神經(jīng),32,第十步：使用射頻消融,,33,,雙極射頻電極作用于纖維環(huán),雙極射頻電極小關(guān)節(jié)囊止血,雙極射頻電極小關(guān)節(jié)囊止血,34,,,35,第十一步：治療椎管狹窄,36,Joimax獨(dú)特的椎管狹窄治療技術(shù),,37,第十二步：處理終板,獨(dú)特的終板處理技術(shù)和器械,38,手術(shù)后3個月,Picking up cars and heavy logs for a living can be a bit demanding. A painful injury to his lower spine forced Strongman and actor Dieter Seidenkranz to take a break and- despite his enormous size and authorative muscles - restrain from his favourite hobby for a while. Dr. Hoogland operated the muscle-man endoscopically in September 2004. As the image shows, Dr. Hoogland and Dieter Seidenkranz were both happy with the surgical result at the 3-month post-operative examination in January 2005, where the Strongman resumed his hobby.,39,術(shù)后病人滿意度,Data are from studies in progress by: Dr. Alfen, Dr. Krzok, Dr. Iprenburg,40,世界范圍快速開展,,41,培訓(xùn)基地,42,多種培訓(xùn)方式,43,我們的資源就是你的資源,44,,我們的資源就是你的資源,45,我們的資源就是你的資源,46,歷史潮流勢不可擋,Drs. Chr. & A. Yeung,47,Thanks!,,48,