1、椎間盤造影 椎間孔成型 碎片摘除,減壓 髓核摘除 纖維環(huán)成型,Joimax椎間孔鏡技術(shù),Joimax的椎間孔鏡技術(shù),椎間盤造影 椎間孔成型 碎片摘除 減壓 髓核成型 纖維環(huán)成型 全脊柱手術(shù),由外向內(nèi)的技術(shù) 適應(yīng)癥廣 創(chuàng)傷更小 學(xué)習(xí)曲線長,多種衍生技術(shù) 椎管狹窄 錐體固定,Joimax椎間孔鏡技術(shù)原理,安全三角區(qū),手術(shù)入路,Joimax椎間孔鏡技術(shù),第一步：手術(shù)前評估,第二步：確定體位,Joimax專利的脊柱手術(shù)專用床,第三步：確定進針路線,C型臂定位,第四步：椎間盤顯影,椎間盤顯影,染色的椎間盤,第五步：放置導(dǎo)絲、導(dǎo)桿、導(dǎo)管,放置導(dǎo)絲、導(dǎo)桿、導(dǎo)管,2020/6/24,16,Access Det

2、ails 2,first cannulated dilator placed over guide wire,first guiding tube placed over dilator,2020/6/24,17,L5-S1專用導(dǎo)桿,第六步：用環(huán)鉆擴孔,綠色：安全，直徑5.0mm。 黃色：注意，直徑6.5mm。 紅色：警惕，直徑7.5mm。,Joimax專利擴椎間孔用環(huán)鉆,環(huán)鉆應(yīng)該防置的正確位置,環(huán)鉆尖端不能超過脊突中間線,用環(huán)鉆去除部分小關(guān)節(jié)突,獨特的L5-S1水平擴孔,Joimax特殊設(shè)計的導(dǎo)桿防止損傷,獨特的L5-S1水平擴孔,第七步：放置工作套管,第八步：放置椎間孔鏡,椎間孔鏡所見,鏡

3、下看到突出髓核碎片,鏡下看到突出髓核碎片和硬膜囊,鏡下看到突出髓核碎片和神經(jīng)根,鏡下看到突出髓核碎片和小關(guān)節(jié)囊,髓核碎片壓迫神經(jīng),第九步：摘除髓核碎片,2020/6/24,29,Transforaminal endoscopic access,6/24/2020,30,摘除髓核碎片,手術(shù)后神經(jīng)解壓,手術(shù)后壓迫解除，神經(jīng)清晰可見,手術(shù)前髓核碎片壓迫神經(jīng),第十步：使用射頻消融,雙極射頻電極作用于纖維環(huán),雙極射頻電極小關(guān)節(jié)囊止血,雙極射頻電極小關(guān)節(jié)囊止血,第十一步：治療椎管狹窄,Joimax獨特的椎管狹窄治療技術(shù),第十二步：處理終板,獨特的終板處理技術(shù)和器械,手術(shù)后3個月,Picking up ca

4、rs 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 endosc

5、opically 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.,術(shù)后病人滿意度,Data are from studies in progress by: Dr. Alfen, Dr. Krzok, Dr. Iprenburg,世界范圍快速開展,培訓(xùn)基地,多