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本研究通过10具尸体的局解和100例腰椎 CT 值进行测量,对经皮腰椎间盘摘除术的侧后方进针途径进行研究,通过50例腰椎对照摄片,设计了一适用于 L_5-S_1椎间盘穿刺的特殊体位和定位方法。结果表明:侧后方进针法为一安全的穿刺途径,但应掌握进针角度宁小勿大的原则;采用笔者设计的特殊体位可使髂骨平均下移2.0cm,同时采用较精确的穿刺点定位可提高 L_5-S_1椎间盘穿刺成功率,130例临床应用成功率达100%。作者首次测得国人与穿刺密切相关的两个穿刺参数值,还就与穿刺通道有关的解剖毗邻组织和穿刺不当可能造成的并发症进行描述和讨论。
In this study, 10 cadaveric and 100 lumbar CT images were measured to study the percutaneous lumbar discectomy after the lateral retrograde needle approach, through the 50 cases of lumbar spinal cord control photographs designed for a L_5-S_1 Intervertebral disc puncture of the special position and positioning method. The results showed that the lateral posterior approach was a safe way of puncturing, but the principle that the angle of the needle should not be bigger than that of the needle should be mastered. Using the special position designed by the author, the average iliac can be moved down 2.0cm, meanwhile, Point positioning can improve the success rate of L_5-S_1 intervertebral disc puncture, and the clinical success rate of 130 cases is 100%. For the first time, the authors measured two puncture parameter values closely related to puncture in China and described and discussed the complications that may be caused by improper puncture and adjacent anatomy of the puncture channel.