Joimax的椎间孔镜技术椎间盘造影椎间孔成型碎片摘除减压髓核成型纤维环成型全脊柱手术由外向内的技术适应症广创伤更小 学习曲线长多种衍生技术椎管狭窄锥体固定1XIQIJoimax椎间孔镜技术原理安全三角区2XIQI手术入路3XIQIJoimax椎间孔镜技术4XIQI第一步：手术前评估5XIQI第二步：确定体位Joimax专利的脊柱手术专用床6XIQI第三步：确定进针路线 7XIQIC型臂定位8XIQI第四步：椎间盘显影 9XIQI椎间盘显影10XIQI染色的椎间盘11XIQI第五步：放置导丝、导杆、导管12XIQI 放置导丝、导杆、导管 13XIQI14XIQI2024/7/2015Access Details 2first cannulated dilator placed over guide wirefirst guiding tube placed over dilator15XIQI2024/7/201616XIQIL5-S1专用导杆17XIQI第六步：用环钻扩孔绿色：绿色：安全，直径5.0mm。黄色：黄色：注意，直径6.5mm。红色：红色：警惕，直径7.5mm。Joimax专利扩椎间孔用环钻18XIQI环钻应该防置的正确位置环钻尖端不能超过脊突中间线19XIQI用环钻去除部分小关节突20XIQI独特的L5-S1水平扩孔Joimax特殊设计的导杆防止损伤21XIQI独特的L5-S1水平扩孔22XIQI第七步：放置工作套管23XIQI第八步：放置椎间孔镜24XIQI椎间孔镜所见镜下看到突出髓核碎片 镜下看到突出髓核碎片和硬膜囊 镜下看到突出髓核碎片和神经根 镜下看到突出髓核碎片和小关节囊 25XIQI髓核碎片压迫神经26XIQI第九步：摘除髓核碎片27XIQI2024/7/2028Transforaminal endoscopic access28XIQI7/20/20242929XIQI摘除髓核碎片30XIQI手术后神经解压手术后压迫解除，神经清晰可见手术前髓核碎片压迫神经31XIQI第十步：使用射频消融32XIQI双极射频电极作用于纤维环 双极射频电极小关节囊止血 双极射频电极小关节囊止血 33XIQI34XIQI第十一步：治疗椎管狭窄35XIQIJoimax独特的椎管狭窄治疗技术36XIQI第十二步：处理终板独特的终板处理技术和器械37XIQI手术后3个月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. 38XIQI术后病人满意度Data are from studies in progress by: Dr. Alfen, Dr. Krzok, Dr. Iprenburg39XIQI历史潮流势不可挡Drs.Chr.&A.Yeung40XIQIThanks!41XIQI