【摘要】 目的 通过人体标本研究评估笔者团队创新的可视可控可定位椎板钻在单通道双介质脊柱内镜中治疗腰椎管狭窄的可行性。方法 供体为 2 具新鲜冰冻的人体标本，人体标本均没有脊柱手术史。使用可视可控可定位的椎板钻结合单通道双介质脊柱内镜对人体标本 L_1～2、L_2～3、L_3～4、L_4～5、L₅～S₁ 5 个节段一侧入路两侧减压，均采用右侧入路。记录建立通道时间、C 型臂 X 线机透视下椎板钻减压时间、透视次数、镜下一侧入路两侧减压时间。结果 在 2 具人体标本上成功进行了 10 个节段减压手术。建立通道时间（4.28±1.42） min、C 型臂 X 线机透视下椎板钻减压时间 （2.75±1.08） min，平均透视次数为 9 次，镜下一侧入路两侧减压时间 （22.04±7.32） min。10 个节段减压未出现硬膜和神经组织损伤。结论 目前的结果表明，可视可控可定位椎板钻在单通道双介质脊柱内镜中一侧入路两侧减压治疗腰椎管狭窄症是安全、高效、彻底减压的可行技术。更多还原

【Abstract】 Objective To evaluate the feasibility of a visually controllable and positionable laminar drilling for the treatment of lumbar spinal stenosis in a single-channel dual-media spinal endoscopy by a human specimen study.Methods The donors were two fresh frozen human specimens,neither of which had a history of spinal surgery.A visual,controllable and positioning laminar drill combined with a single-channel dual-media spinal endoscope was used to decompress L_1-2,L_2-3,L_3-4,L_4-5,and L₅-S₁ on both sides of the five segmental approaches,all using a right approach.The time of channel establishment,C-arm fluoroscopic drill decompression time,fluoroscopy times,and decompression time on both sides of the under-lens approach were recorded.Results Ten segmental decompression procedures were successfully performed on two human specimens.The time to establish the channel was （4.28±1.42） min,the time to decompress the lower laminectomy drill by C-arm fluoroscopy was （2.75±1.08） min,the average frequency of fluoroscopy was 9,and the decompression time on both sides of the approach under the microscope was （22.04±7.32） min.Dural and nerve tissue injuries were not observed in 10 levels of decompression.Conclusions Our present results indicate that the visual controllable and locatable laminar drill is a safe,efficient and feasible technique for complete decompression of lumbar spinal stenosis by unilateral approach and bilateral decompression in single-channel dual-media spinal endoscopy.更多还原