1、椎间盘造影椎间盘造影椎间孔成型椎间孔成型碎片摘除碎片摘除减压减压髓核摘除髓核摘除纤维环成型纤维环成型Joimax椎间孔镜技术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Joimax椎间孔镜技术原理 安全三角区手术入路Joimax椎间孔镜技术第一步：手术前评估第二步：确定体位Joimax专利的脊柱手术专用床第三步：确定进针路线 C型臂定位第四步：椎间盘显影 椎间盘显影染色的椎间盘第五步：放置导丝、导杆、导管 放置导丝、导杆、导管 2022-7-1916Access Details 2f
2、irst cannulated dilator placed over guide wirefirst guiding tube placed over dilator2022-7-1917L5-S1专用导杆第六步：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环钻应该防置的正确位置环钻尖端不能超过脊突中间线用环钻去除部分小关节突独特的L5-S1水平扩孔Joimax特殊设计的导杆防止损伤独特的L5-S1水平扩孔第七步：放置工作套管第八步：放置椎间孔镜椎间孔镜所见镜下看到突出髓核碎片 镜下看到突出髓核
3、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 髓核碎片压迫神经第九步：摘除髓核碎片2022-7-1929Transforaminal endoscopic access7/19/202230摘除髓核碎片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第十步：使用射频消融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 第十一步：治疗椎管狭窄Joimax独特的椎管狭窄治疗技术第十二步：处理终板独特的终板处理技术和器械手术后3个月Picking up cars and heavy logs for a living can
4、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 s
5、hows,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.术后病人满意度0%10%20%30%40%50%60%70%excellentgoodlesscontentpoorn=360Data are from studies in progress by:Dr.Alfen,Dr.Krzok,Dr.Iprenburg
