The CT-guided intervention for lumbar disc herniation is more accurate2010-08-11 08:22:38 Author：eceden Source：Panyu Daily Contributor□ Our reporter Zhan Haiyan Correspondent Cui Weifeng Guangzhou Panyu District Hospital of Traditional Chinese Medicine Department of intervention Xu Guozeng lumbar disc herniation is a common and frequent disease that seriously affects the work and quality of life of some patients. According to the report, the clinical manifestation of the disease is lumbar pain or lower limb pain and numbness, and in severe cases, it can manifest as walking weakness or even paralysis. According to Dr. Xu Guozeng, chief physician of the CT Department of the District Hospital of Traditional Chinese Medicine, lumbar disc herniation, whether conservative or surgical treatment, is aimed at relieving the compression of the spinal cord or nerve roots as well as eliminating nerve root inflammation and edema. At present, interventional treatment has become one of the main treatment methods for lumbar disc herniation. In the District Hospital of Traditional Chinese Medicine, in addition to the various conventional therapies carried out by the Department of Orthopedics for herniated discs, the CT-guided treatment of herniated lumbar discs carried out by CT doctors is also recognized and welcomed by many patients. The lumbar disc herniation should be treated by typing According to the introduction, there are countless lumbar disc herniation treatment methods and drugs, but the long treatment and recurrent attacks still plague many lumbar disc herniation patients, one of the big reason is not to do typing treatment. He points out that doctors must understand how herniated discs are staged in order to better determine whether patients need minimally invasive interventional surgery or open surgery or conservative therapy. Generally speaking, lumbar disc herniation can be divided into four types: bulging disc, herniated disc, prolapsed disc, and free disc. The first two cases can achieve better treatment results by conservative treatment, while the last two cases usually require surgery. The CT-guided minimally invasive intervention for lumbar disc herniation carried out in the district hospital is mainly for the latter two types of patients, and the CT-guided treatment is more accurate. Usually this type of surgery is performed under X-ray, and the collagenase injected into the disc often causes the patient to feel pain even after the surgery because the positioning is not clear and accurate. Combining domestic and international treatment experience, Xu Guozeng et al. used CT guidance to inject collagenase into the herniated disc for minimally invasive treatment. A large number of subsequent cases showed that under CT guidance, it was possible to monitor whether the needle tip position could accurately enter the patient’s herniated disc and better guarantee the treatment effect. The introduction of laser therapy to accelerate the efficacy of Xu Guozeng pointed out that there is no need to be nervous when suffering from lumbar disc herniation, generally the patients with lumbar disc bulging and protrusion can recover with bed rest and conservative treatment such as taking Chinese medicine; patients with lumbar disc herniation (prolapse, free type) more serious can achieve good results with CT-guided intervention. The traditional open surgery is also mature and reliable now. For patients with more serious lumbar disc prolapse and free, it would take a long process if treated by collagenase injection alone. For this reason, they came up with the idea of laser vaporization of a portion of the herniated disc, which leads to volume reduction and decompression. This was followed by targeted collagenase injection therapy, which effectively accelerated the treatment process for patients with severe disc herniation. The procedure sets a safe area according to the patient, when this intervention is performed, the doctor will first do a routine CT scan to select the puncture level, puncture point and needle approach, the principle of which is to avoid important blood vessels and nerves and other structures to determine the shortest safe needle approach to the percutaneous puncture target. The CT scanner cursor is used to measure the angle and depth of the needle entry to set the safe area for the procedure. Xu Guozeng said that minimally invasive interventional treatment using CT guidance has the characteristics of less trauma, faster recovery, fewer complications, lower cost, and similar treatment mechanism to open surgery compared to open surgery or other minimally invasive procedures. Since the whole process of interventional surgery needs to be guided by CT, the attending physician needs to be proficient in the use of CT and knowledge of lumbar disc herniation treatment. In 2002, the results of this technique passed the science and technology achievement appraisal of Guangzhou Science and Technology Bureau and was recommended to be published in the “National Science and Technology Achievement Network”. The results of the scientific and technological research were published in the National Science and Technology Achievement Network. Nowadays, patients who have received this surgery have referred their friends and relatives to the CT Department of the District Hospital of Traditional Chinese Medicine for treatment, believing that this treatment has opened up a new way out for patients with severe disc herniation with higher safety and more obvious efficacy outside of open surgery, and is the first choice for patients with more severe lumbar disc herniation (prolapsed, free type).