Minimally Invasive Spinal Cord and Column Center
Neurosurgery Ward 1 is one of the key departments of the Neurology Center, a first-class specialty specializing in the treatment of spinal cord diseases. It has modern diagnosis and treatment equipment, such as MRI, spiral CT, DSA, operating microscope, intervertebral foramoscope, spine navigator, high-speed grinding drill, intraoperative nerve monitor, cell biology laboratory, etc. The key department of the hospital is also a postdoctoral station of Tsinghua University. Relying on the strong scientific research strength of Tsinghua University, the spinal neurosurgery department integrates the advantages of neurosurgery, microsurgery and spinal surgery, and has a high level in the diagnosis and treatment of cervical spondylosis, disc herniation and vertebral compression fracture.
I. The latest concept: integrated intervertebral disc herniation treatment model
By summarizing the domestic and foreign literature, lumbar disc herniation can be divided into four steps of treatment.
First stage: mild or moderate herniation, firstly, standardized conservative treatment for 3 months, most of which can relieve the symptoms without surgical treatment.
The second stage: if conservative treatment does not provide satisfactory relief, minimally invasive interventional treatment is recommended, commonly used means include radiofrequency ablation of the disc, low-temperature plasma, triple oxygen therapy, collagenase ablation of the disc, nerve root block, etc.
All of the above methods are indirect decompression and can treat 80% of patients with herniated discs, but there is not a single method that can achieve that efficacy and should be applied in combination, such as low-temperature plasma + triple oxygen therapy, which is effective.
The third stage: the above minimally invasive surgery can not be solved, the symptoms gradually aggravate, and seriously affect the daily work and life need open surgery (for severe herniation, prolapse or free, etc. early surgical treatment is recommended). The surgical methods are: foraminoscopic discectomy and microscopic discectomy
The application of foraminoscopy and microscopy allows herniated discs to achieve the ultimate minimally invasive treatment, greatly increasing the efficiency while making up for the deficiencies of the above-mentioned interventional disc surgery. It also avoids the complications of open surgery.
Fourth stage: rehabilitation. In a broad sense, rehabilitation is treatment, including: functional exercise, pain and other residual symptoms treatment, while what we usually consider as treatment should include rehabilitation treatment.
Therefore, many patients with lumbar disc herniation are eager to have a more systematic and individualized treatment plan to ensure maximum therapeutic efficacy while minimizing trauma. Systematic treatment requires multidisciplinary efforts, but many hospitals in China still provide a single treatment for lumbar disc herniation, resulting in inconsistent treatment for patients. The Spine and Spinal Cord Neurosurgery Center of Tsinghua University Yuquan Hospital integrates neurosurgery, spine surgery, pain medicine and rehabilitation to establish a systematic treatment center for lumbar disc herniation and cervical spondylosis.
All-in-one surgery method
1.Low temperature plasma disc nucleus pulposus ablation
Professor of the British Institute of Minimally Invasive Orthopaedics praised: “This treatment technology is the most advanced minimally invasive spinal surgery, which is the precise and controlled decompression and shaping of the intervertebral disc through plasma low temperature ablation and precise thermal wrinkling technology. “The diameter is only 1 mm, which is truly minimally invasive, safe and green.”
2.Trioxic nucleus pulposus chemical ablation
By injecting ozone into the diseased intervertebral disc, it destroys and dissolves the proteoglycan molecules in the nucleus pulposus matrix, causing the nucleus pulposus to atrophy, degenerate and shrink in size, thus causing the fibrous ring to retract and relieving the nerve root compression. Ozone can also inhibit local immune response, reduce sterile inflammation of nerve roots and eliminate edema of nerve roots, thus achieving the purpose of anti-inflammatory and analgesic for lesioned tissues
3.PLDD (laser interdiscal ablation)
Using the unique optical fiber to introduce laser into the intervertebral disc, the heat radiated by the laser will vaporize part of the nucleus pulposus tissue, reduce the internal pressure of the intervertebral disc, eliminate inflammatory factors, improve the blood circulation of the affected nerve, so as to achieve the purpose of treatment.
4.Radiofrequency pain nerve block
Radiofrequency current is a kind of high frequency alternating current with a frequency of 100kHz-3MHz, which is used for the treatment of disc herniation, that is, through the ablation electrode in the intervertebral disc, radiofrequency energy is emitted through the exposed part of the tip of the rod, thus vaporizing part of the nucleus pulposus of the disc and achieving the purpose of decompression of the nerve roots, arteries and spinal cord around the disc, so as to eliminate and relieve clinical symptoms;
5.Intervertebral foraminoscopic discectomy
The advantage of foraminoscopic discectomy is that the whole operation is completed under local anesthesia and the patient is awake throughout, which not only avoids the risk of anesthesia, but also reduces the chance of nerve root injury. The patient’s skin incision is less than 1cm, and the trauma is minimal.
6. Microscopic discectomy
Microscopic cervical and lumbar disc herniation resection has small opening, little trauma, less bone destruction, good surgical stability, generally does not require internal fixation surgery, and better nerve exposure, lower incidence of nerve injury, and reliable efficacy.
Minimally invasive treatment of intractable pain due to discs: radiofrequency ablation of the dorsal root of the spinal ganglion
Indications.
1. Intervertebral disc herniation is not serious but there is stubborn back and leg pain or neck and shoulder pain
2. Intractable pain after lumbar disc herniation surgery
3. Older people with diabetes, heart disease and other diseases that are not suitable for open surgery