Lumbar disc herniation is a common lumbar disorder in clinical practice, and patients suffer from back and leg pain for years, which can even lead to incontinence and even paralysis. Over the years, Li Jingzhao, director of orthopedics at Shandong Provincial Chest Hospital, has devoted himself to the treatment of this disease with small incisions and safety. Recently, director Li led his team to focus on research breakthroughs “intervertebral foramenoscopy”, a new minimally invasive diagnosis and treatment of lumbar disc herniation that has not been carried out much in China, and successfully completed the first case of intervertebral foramenoscopy discectomy on March 15th. The patient recovered well after the operation and achieved the expected results. Zhang Qiang, Department of Orthopedic Surgery, Shandong Thoracic Hospital It is understood that the operation better overcomes the shortcomings of the traditional surgical methods, representing the highest level of minimally invasive treatment of herniated discs at home and abroad. Orthopedics successfully carried out this technology marks the level of minimally invasive treatment of lumbar intervertebral disc herniation in Shandong Provincial Chest Hospital has reached a new height. The reporter heard in the operating room: keyhole technology “significantly reduce” the patient’s symptoms The reporter learned from Director Li: intervertebral foramenoscopy technology, not the traditional discoscopy technology and simple ablation (including laser, radiofrequency, ozone ablation, etc.), can be most of the intervertebral disc herniation and neurogenic stenosis patients to relieve their pain, which is the medical development, device improvement and medical technology to improve the level of minimally invasive treatment. This is a result of medical advances, improved equipment, and improved medical technology. Just one month later, on April 15, Dr. Li will perform his second intervertebral foramenoscopy surgery. The day’s surgery also ushered in four special guests: two doctors from outside hospitals came to learn and observe, and two reporters from this newspaper came to the operating room for an on-site interview. This year, more than fifty years old Xing, is a highway bureau employees, suffering from many years of disc herniation. 2 months ago Xing’s condition is getting worse and worse, legs and feet can not move, serious need to walk on crutches, often night pain can not sleep. He went to a number of hospitals to seek treatment, but the treatment is not effective, and finally a friend recommended that he came to Shandong Provincial Chest Hospital diagnosis and treatment. After being admitted to the hospital, he was diagnosed with a herniated disc in the lumbar four or five vertebrae, and was recommended to undergo a lumbar discectomy. The first time he heard of the operation, he was a little afraid of the operation. This is a new minimally invasive technique that is not a developmental surgery. In simple terms, it is to open a keyhole-sized incision in your lower back and place a 7.5mm surgical working channel through the intervertebral foramen to directly place a person inside the intervertebral disc or vertebral canal, and then take out the protruding or detached disc pressurization under direct endoscopic visualization. The surgery was scheduled for April 15 at 1:30 pm. After all the preoperative examination, Xing moncler outlet online no contraindications to surgery, can be carried out lumbar discectomy. At 1:30 p.m., the reporter followed Director Li into the operating room, the patient has long been prone on the operating table, several doctors and nurses in the preparation of surgical equipment. Surgery is carried out under local anesthesia. After injecting the anesthetic, Director Li positioned the disc under C-arm supervision and communicated with Mr. Xing from time to time. “How does it feel?” “Feeling very good, I completely trust Director Li’s medical skills!” “Just let me know anytime you have any discomfort.” “Okay.” After successful localization, the doctor puts in guide rods, catheters, and reaming drills one by one, and the probe in the endoscope enlarges the protruding position on the computer screen, and the “white” material is the protruding disc seen by the naked eye. Director Li, with the help of the probe and years of clinical experience, accurately and quickly removes the protruding disc bit by bit. Director Li told reporters that this surgical method is through a specially designed intervertebral foraminoscope and the corresponding supporting spinal minimally invasive surgical instruments, imaging and image processing system, as well as the ellman dual-frequency radiofrequency machine, a spinal minimally invasive surgical system. While completely removing the protruding or prolapsed nucleus pulposus, it removes osteophytes, treats spinal stenosis, and can use radiofrequency technology to repair the broken annulus fibrosus. One hour later, the surgery was successfully completed. Xing’s joy was not overflowing, very happy to say to Director Li, I feel that the pain is significantly reduced, and even lifted one leg on the spot, which could not be moved before the operation. The first thing you need to do is to get your hands dirty. The doctor looked like he was embroidering and closed the keyhole wound with just one stitch. The patient was then pushed out of the operating room. Director Li finally breathed a sigh of relief, “Xing grandfather just need to bed rest for two or three days, you can walk on the ground!” Edit: Outsiders see the fun, insiders see the doorway. Several huge machines are placed in the operating room of about twenty square meters, although it is bulky, but the effect is obvious. In the operating room, the reporter could not help but witness the superb medical skills of Director Li, and also realized the meticulous and rigorous attitude, coupled with the clinical side of Director Li’s recent decades of anatomical knowledge of the posterior intervertebral foramen region, which made the perfect end of the operation. Expert Opinion: Intervertebral foramenoscopy technology – minimally invasive green surgery lumbar disc herniation is the cause, lumbar disc herniation is the effect Mention of lumbar disc herniation, I believe that many people are not unfamiliar with it, but Director Li reminded that although this is a common disease and frequent occurrence of the disease, there are a lot of misunderstandings. Director Li told reporters that the lumbar disc herniation is due to the lumbar intervertebral disc long-term pressure from the weight of the body’s upper body, the human body often do, forward flexion, backward extension, and rotation and other actions of the lumbar intervertebral disc gradual wear and tear degradation, encountered inappropriate external forces, such as sudden weight-bearing, sneezing, defecation, etc., resulting in intervertebral disc injury. The annulus fibrosus ruptures and the nucleus pulposus protrudes from the rupture. This is a lumbar disc herniation. When a disc herniates, if the herniated material does not compress the nerve roots or spinal cord, the patient will not experience symptoms. If the protruding nucleus pulposus presses on the nerve roots or spinal cord, it will produce a series of clinical symptoms of lumbar disc herniation. Director Li also pointed out that these two concepts are also the most easily confused patients, after 40 years of age, through the CT or MRI images show that many people have herniated lumbar intervertebral discs, but there is no symptom, as normal people, this is because there is no compression of the nerve roots or spinal cord. This allows the patient to ignore the presence of a herniated disc and continue with his or her work life. However, with the continued compression of the upper body, the intervertebral space will gradually become narrower and the herniation will become larger and larger, and once the nerve root is compressed, clinical symptoms will appear. So the clinical point: lumbar disc herniation is the product of lumbar disc herniation. Conservative treatment is ineffective to choose minimally invasive surgical treatment Director Li said that the diagnosis of lumbar disc herniation is not difficult, the patient as long as the orthopedic department or spine surgery clinic, generally through the CT or MRI examination can be clearly diagnosed. Standardized conservative treatment includes: oral non-steroidal anti-inflammatory drugs, neurotrophic drugs and supplemented with proprietary Chinese medicines in order to activate the meridians and channels, appropriate bed rest, regular physical therapy, most patients can achieve the elimination of symptoms, the condition of the results of stabilization. However, once the condition recurs and conservative treatment is ineffective, surgery should be actively considered. Traditional surgical treatment of lumbar disc herniation requires more or less removal of part of the normal vertebral structure, which may lead to postoperative spinal instability, and even sometimes requires the assistance of pedicle screw fixation and fusion, which makes the surgery more traumatic. Therefore, most patients are hesitant to undergo surgery and delay their condition. This is not the case with intervertebral foraminoscopy, which has its own unique advantages. The surgeon only needs local anesthesia to complete the surgery, instead of the traditional general anesthesia; the patient is fully awake during the entire surgery, usually “chatting” with the surgeon while watching the surgery with the endoscopic camera while the surgeon easily completes the surgery; since the intervertebral foramenoscopy technology only uses the “normal foramina” of the spine, it is not necessary to use the endoscopic camera for the surgery. Because the intervertebral foramen technology only uses the “normal foramen” of the spinal column to remove the disc tissue that oppresses the nerves, and does not need to remove part of the normal spinal structure to remove the disc as in traditional surgery, the foramenoscopic surgery does not need to do the internal fixation and fusion, i.e., it does not need to hit the nails to fix the support for the lumbar vertebrae. Because of these minimally invasive advantages, the intervertebral foraminoscopy technique is also known as a spinal “no-open” surgery, and has been hailed by the medical community as the “gentlest and least invasive treatment for lumbar synostosis” in the world. The procedure itself is not complicated, but due to the delicate operation and the many steps involved, the average operating time is 60-90 minutes. The surgery only requires a 0.8 cm skin puncture, there is almost no intraoperative bleeding, and the body recovers quickly. Patients can get out of bed and walk and take care of their own bowel movements after the surgery, with an average of 4-7 days in the hospital, and can usually return to work after 3-6 weeks of recuperation at home after being discharged from the hospital. Because there is no need to hit the nail fixed fusion, treatment costs are greatly reduced, in the high cost of treatment in today’s society, can be called “green surgery”. Director Li finally reminded that although the advantages of intervertebral foraminoscopy technology over traditional surgery are obvious, but it is not suitable for all patients with lumbar synostosis. If patients with lumbar herniation are not diagnosed and treated in a timely manner, the delayed condition of the lumbar spinal canal will often be combined with the proliferation of joints, ligamentous hypertrophy and other conditions, which leads to lumbar stenosis, that is, the narrowing of the nerve channel and the resulting nerve walking obstruction and compression, at this time, intervertebral foramenoscopy surgery is not easy to lift the above problems; In addition, if the patient is not only lumbar disc protrusion is combined with the lumbar spinal instability and even lumbar vertebrae slipped and loosened, is also one of the contraindications for intervertebral foramenoscopy surgery. In addition, if the patient has lumbar instability or even lumbar spondylolisthesis loosening in addition to lumbar disc herniation, it is also one of the contraindications for intervertebral foramenoscopy. Editor: Minimally invasive is a concept, a philosophical idea, and also a real clinical application technology. With the rapid evolution of minimally invasive techniques in recent years, the concepts and methods of spine surgery are being changed more and more radically. The emergence of new intervertebral foraminoscopy technology has made the treatment of lumbar disc herniation enter a substantial minimally invasive era. With the increasing popularization of intervertebral foramenoscopy technology in Orthopaedic Department of Shandong Chest Hospital, it is believed that it will bring the gospel of minimally invasive and low-cost treatment to a large number of patients suffering from lumbar and leg pain. Introduction The Orthopedics Department of Shandong Provincial Chest Hospital East Campus is a comprehensive orthopedics department focusing on “spine, joints, orthopedics, trauma and tuberculosis”. 1. Spine Surgery: At present, the department carries out the specialties of spine trauma, degeneration (cervical spondylosis, lumbar disc herniation, spinal stenosis, vertebral body slippage), correction of spinal deformity, spinal tumor, etc. Recently, the department has introduced the concept of minimally invasive spine surgery, and has introduced the minimally invasive treatment of lumbar disc herniation, spinal stenosis and other spinal degenerative diseases by intervertebral foraminoscopy, as well as percutaneous pedicle screw internal fixation, which is minimally invasive to treat the patients with spinal disorders, and has achieved good results. The results. Advantages of intervertebral foramenoscopy surgery: 1. Surgery under local anesthesia, the patient stays awake, high safety. 2. get out of bed in 4 hours after surgery, can be discharged from the hospital in 3 days after surgery, short hospitalization period, simple accompanying. 3. maximize the maintenance of intervertebral disc structure and stability. 4. won’t damage and irritate the nerve root or dural sac. 5. microscopically remove the herniated nucleus pulposus, decompression is sufficient. 6. scarring is light, low risk of infection, fast recovery. 7. the result is not satisfactory. The results are not ideal, and can be repaired by open surgery. 2. Arthroplasty: With the accelerated aging process in China, more and more joint degenerative changes such as frozen shoulder and osteoarthritis of knee joints have seriously affected the quality of life of patients. In order to relieve patients’ pain and the fear of “operation”, the department spends a huge amount of money to purchase arthroscopy and other minimally invasive instruments, eliminating the traditional treatment means of “operation” and adopting minimally invasive treatment of joint diseases, with less trauma and faster recovery. 3. Orthopedic Surgery: Bone and joint deformities of the limbs due to congenital or acquired factors, bunion, adult symptomatic flatfoot deformity, bringing serious impact on patients, with the improvement of people’s standard of living, the demand for medical treatment of such diseases is growing, the Department of foot and ankle, limbs and other parts of the orthopedic surgery, can relieve the pain of the majority of patients. 4. Orthopedics of Trauma: Bone and joint trauma of limbs is the most common disease in orthopedics at present. Closed fracture of limbs, using manipulation to reset, small splint (plaster external fixation), is the medical project inherited by our hospital with the characteristics of traditional medicine; at the same time, our hospital carries out the internal and external fixation system for treating the fracture of limbs, and percutaneous cement infusion for treating the fracture of vertebra of spine, which is early in activity and quick in recovery, and has achieved good clinical efficacy. 5. Surgery for bone and joint tuberculosis: through surgical intervention, most patients with bone and joint tuberculosis can be cured. On the basis of regular anti-tuberculosis treatment, for spinal tuberculosis, we carry out one-stage anterior (posterior) lesion removal + posterior (anterior) bone grafting and internal fixation, which can not only completely remove the lesion, but also stabilize the spine, accelerate the healing process, reduce the deformity, and shorten the time of patients lying in bed, which effectively protects the patients’ ability to work; for articular tuberculosis, we carry out one-stage removal of the lesion of joint tuberculosis joint fusion, one-stage arthroplasty for joint tuberculosis, and one-stage arthrodesis for joint tuberculosis, with good clinical results. For joint tuberculosis, our hospital has carried out the arthroplasty of one-stage removal of joint tuberculosis fusion and one-stage arthroplasty of joint tuberculosis, which completely cured joint tuberculosis and restored patients’ joint mobility, and was highly praised by patients. Combined with CT three-dimensional reconstruction to evaluate the degree of vertebral destruction, we have formulated a classification system for spinal tuberculosis, which guides the principle of surgical fixation, minimizes the fusion of normal vertebral space and avoids complications caused by improper choice of fixation method.