2024年8月9日,中德脊柱外科視頻會議于汕頭大學(xué)醫(yī)學(xué)院第一附屬醫(yī)院舉行。會議邀請德國慕尼黑哈拉興骨科醫(yī)院脊柱中心主任、歐洲脊柱學(xué)會(EUROSPINE)秘書長Siepe教授就脊柱微創(chuàng)手術(shù)相關(guān)問題進行演講。汕頭大學(xué)醫(yī)學(xué)院第一附屬醫(yī)院骨科胡軍教授致辭,胡軍教授首先致謝Siepe教授參與此次在線學(xué)術(shù)會議,指出附一院骨科長期以來堅持學(xué)術(shù)交流國際化,人才培養(yǎng)國際化,帶動促進骨科學(xué)科發(fā)展。骨科醫(yī)學(xué)研究中心許建坤副主任及黃鐘煉副主任醫(yī)師共同主持會議。Siepe教授以《全內(nèi)鏡減壓手術(shù)中減壓不充分——原因及避免方法》作專題演講。Siepe教授首先介紹脊柱微創(chuàng)手術(shù)的發(fā)展及其治療退變性椎管狹窄的優(yōu)勢,詳細介紹如何在內(nèi)鏡下對退變性腰椎管狹窄進行充分減壓。教授通過典型病例,結(jié)合手術(shù)視頻和圖片,從手術(shù)適應(yīng)證、手術(shù)入路及手術(shù)器械使用等方面細致講解全內(nèi)鏡減壓手術(shù)的要點。Siepe教授指出,該手術(shù)最重要的是術(shù)者要通過肉眼觀察椎管和神經(jīng)根是否得到直接、充分減壓,同時強調(diào)學(xué)習(xí)脊柱內(nèi)鏡手術(shù)是循序漸進的,鼓勵年輕醫(yī)生從簡單的病例入手,逐步熟練掌握內(nèi)鏡技術(shù)。分享結(jié)束后,參會者與Siepe教授就脊柱穩(wěn)定性與減壓之平衡、年齡因素、非退變性疾病的內(nèi)鏡適應(yīng)證和禁忌證等相關(guān)問題進行了一系列的深入討論。汕頭大學(xué)醫(yī)學(xué)院第一附屬醫(yī)院骨科黃鐘煉副主任醫(yī)師分享了一例腰椎間盤突出癥導(dǎo)致急性神經(jīng)根功能障礙的病例,并與Siepe教授就手術(shù)術(shù)式和入路展開討論。針對此類急性患者,Siepe教授建議先解除椎間盤突出對神經(jīng)的壓迫,避免神經(jīng)損害進一步加重導(dǎo)致馬尾綜合征,術(shù)后再根據(jù)患者情況決定是否二次手術(shù)。黃鐘煉副主任醫(yī)師對該患者的治療方案與Siepe教授一致,為患者進行了單側(cè)雙通道內(nèi)鏡下髓核摘除術(shù),術(shù)后患者效果滿意。Siepe教授對該病例的處理表示贊同,指出該病例同時存在在慢性退變的基礎(chǔ)上出現(xiàn)急性癥狀,診療具有非常重要的臨床意義。最后,Siepe教授感謝胡軍教授及其團隊的邀請,期待未來有更多機會進行學(xué)術(shù)交流。
On August 9th, 2024, Sino-German Video Conference on Spine Surgery was held at the First Affiliated Hospital of Shantou University Medical College.Prof. Siepe, Head of Spine Center of Sch?n Klinik München Harlaching and Secretary General of EUROSPINE, was invited to give a lecture on minimally invasive spine surgery.Prof. HU Jun, Director of the Dept. of Orthopedics of the First Affiliated Hospital of Shantou University Medical College, addressed an opening speech. He first thanked Prof. Siepe for attending the conference online, and said that the Dept. of Orthopedics of the hospital has been adhering to internationalization of academic exchange and talent cultivation so as to promote the development of orthopedic specialty.Deputy Directors XU Jiankun and HUANG Zhonglian of Orthopedics Medical Research Center of the hospital jointly moderated the conference.Prof. Siepe delivered a special speech on "Insufficient Decompression during Full Endoscopic Decompression – Why and How to Avoid it".First, Prof. Siepe introduced the development of minimally invasive spine surgery and its advantages on treating degenerative spinal stenosis, then illustrated in detail how to perform sufficient decompression for degenerative lumbar spinal stenosis under endoscope.With typical cases, surgical videos and images, Prof. Siepe stressed key points of full endoscopic decompression in terms of surgical indications, approaches and manoeuvre of instruments.According to Prof. Siepe, the most essential part of the surgery is that surgeons should confirm with their eyes if the spinal canal and nerve root are decompressed directly and sufficiently.Also, he emphasized that surgeons should learn spinal endoscopic technique step by step, and encouraged young surgeons to start with easy cases and master the technique gradually.After Prof. Siepe's sharing, he and the audiences had in-depth discussions on balance of spinal stability and decompression, the influence of age on surgical plan, indications and contraindications of endoscopy for non-degenerative diseases, etc.Deputy Director HUANG Zhonglian of the Dept. of Orthopedics of the hospital shared a case of lumbar disc herniation which led to acute neurological defects, and discussed with Prof. Siepe on surgical methods and approaches.For patients with acute symptoms, Prof. Siepe recommended to first relieve the compression of disc herniation on nerve roots to avoid the progression of neurological defects which could progress into cauda equina syndrome, then to decide if a second surgery is needed based on patients' postoperative condition.Deputy Director HUANG Zhonglian had chosen the same surgical plan as Prof. Siepe suggested, performing a discectomy with UBE for the patient. And the patient was happy after the surgery.Prof. Siepe appreciated his solution and case sharing, for the case is featured with chronic degeneration as well as acute symptoms and has significant value for clinical diagnosis and treatment.At last, Prof. Siepe thanked for the invitation from Prof. HU Jun and his team, and looked forward to more opportunities for academic exchanges in the future.