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顯示包含「水刀」標籤的文章。顯示所有文章

10/31/2012

個案分享 - 坐骨神經痛纏擾難消




剛滿卅歲的Kathy常要到外地公幹。一次旅程提行李時扭傷腰部,自此左小腿感痛楚,並一直蔓延至左大腿和臀部。醫生安排腰椎磁力共振素描,證實她腰椎神經受壓引致坐骨神經痛。相信是她扭傷時,脊椎骨之間的椎間盤突出壓迫神經線。醫生說她的椎間盤像肚腩般膨脹突出,但不算嚴重,用物理治療或脊醫把它推回原位便可。但三個月過去,腳痛沒有減少,背痛反而增加,影響工作。醫生曾提及椎間盤切除手術,但要全身麻醉及切除部份脊椎硬骨和小關節,分分鐘得不償失,令她十分困擾。


後來她在網上發現有「水刀」治療椎間盤突出,便找醫生了解一下。



「水刀」是一條直徑五毫米的幼細管道,經過訓練的專業醫師在影像學的幫助下,將幼針經皮膚進入椎間盤,高速水流通過該幼細管道切割病變椎間盤突出的部分,並將之抽出體外,令椎間盤縮小,不再壓著神經線,痛楚隨之消失。



這個手術的好處是傷口細小、無高溫的不良作用、無需全身麻醉、無需切除部份脊椎硬骨和小關節,安全性高,術後住院幾小時便可離開。這種方法較適合年輕、沒有骨刺和膨漲型椎間盤突出的患者。



Kathy
了解後接受「水刀」手術,痛楚迅速消除。醫生叮囑她,拉傷的椎間盤需要時間復元,患者在之後幾個月要特別小心不要再傷腰部。Kathy終於可以擺脫痛楚。
 
以上所提供的資訊僅作為教育及參考用途,如果你有任何醫療問題,
應向神經外科醫生查詢,而不應單倚賴以上提供的資料。

1/18/2011

Hydrodiscetomy: Cutting with Water

Hydrodiscetomy is solving unmet needs and improving outcomes in spine surgery by providing fluidjet-driven medical devices for use in ‘open’ and ‘minimally
invasive’ spine procedures.

The products empower neurosurgeons to simultaneously cut, ablate, and remove hard and soft tissue quickly, safely, and effectively— without the collateral thermal or mechanical trauma of other surgical modalities. Imagine being able to remove tissue during back
surgery via an opening the size of a straw—with the aid of a hair-thin, 600-miles-per-hour stream of water, instead of a one- to two-inch incision from an ‘open’ surgery with a
scalpel. Although high-pressure water jets have been employed for many years in
industrial cutting applications, this technology is not easily adapted for use in medicine
because of the unique technical requirements of surgery:

(1) the working fluid must be sterile;
(2) the tools must be tiny and easily maneuverable;
(3) the pump system must be small enough to fit in any operating room; and,
(4) the devices must be safe.

Hydrodiscetomy has overcome the major barriers to the transfer of fluidjet technology from industrial to surgical applications with significant technical innovations. As a result, a growing number of neurosurgeons are using Hydrodiscetomy to wash away patients’ pain in a variety of back procedures. Unique to Hydrodiscetomy’s devices is the use of a ‘collector’ tube, not only to capture the fluidjet stream, but also to create a powerful ‘Venturi’- and-morcellation effect at the active site—resulting in tissue being drawn into the collector tube and thus away from the operative site, without the need for an external suction connection. This also allows optimal visibility during operation of the device—particularly important in spine procedures, where the surgical site is surrounded by vital structures such as nerves and blood vessels. A further major advantage of Hydrodiscetomy is the ability to achieve ‘selective’ tissue excision. The tissue selectivity benefit allows spine surgeons to quickly and safely remove appropriate tissue, such as disc nucleus, without damaging the surrounding harder tissue or vertebral endplates. These advantages illustrate the power and versatility of Hydrodiscetomy to provide solutions to the spine surgeon, enabling efficient surgical procedures and optimal patient outcomes.

Reference: http://www.minimally-invasive-centrehk.com/english/resources/resources_neurosurgery.html
http://www.youtube.com/user/HKHealthConcern#p/u/5/pFLIV3UfQgg

The above information serves as educational reference only, you should consult your neurosurgeon for diagnosis, treatments and surgeries.

1/03/2011

水刀治療椎間盤神經痛 (參考資料: www.brainspine.com.hk)


原來腰椎也可以做微創手術 ,痊癒後就不會有疤痕,慢著,腰椎有很多神經線做微創手術會否有危險做每個手術都有一定的風險,至於微創手術的過程,藍明權腦﹝神經﹞外科專科醫生,其中有三種類型

水刀手術
水刀是一條這麼細的管道經過皮膚到椎間盤裡面在椎間盤裡面抽掉一部份突出的椎間盤,令椎間盤縮小一點就不會壓著神經線,這種方法適合膨漲型的椎間盤突出適合較年青,膨漲型患者,年輕的病人,沒有骨刺的病人,但有些病人的椎間盤突出已經完全脫離­椎間盤可能不太適合用

內視鏡
內視鏡直徑只有8毫米有些很細小的儀器. 內視鏡手術:適合椎間盤完全脫離之患者,可以穿過這個儀器將裡面突出的椎間盤清除當然­若年紀很大已經有骨刺,很硬的骨形成了而造成椎間盤突出,壓著神經線可能要用相對較大的手術儀器

管道式微創手術
適合較年長,有骨刺之患者,大約16毫米用細小的儀器去做清除骨刺,突出的椎間盤手術會在無菌的手術室在完全消毒的狀況下,進行手術過程也會有一個特別的X光來透視病人的身體,放入手術儀器時可直達椎間盤的傷口做完微創手術通常休息幾小時就可以開始活動最初一星期,建議別太操勞待肌肉等恢復之後可以回復正常活動坐骨神經痛,我們通常建議病人可以先接受物理治療或藥物治療,若經過一段時間譬如六星期也無法治­療的話,可能需要考慮手術的治療. 用什麼方法治療要因應每個病人的身體狀況來決定

以上所提供的資訊僅作為教育及參考用途,如果你有任何醫療問題,應向自己的神經外科醫生面對面查詢,而不應單倚賴以上提供的資料。