前入路经腹L5／S1椎间盘髓核摘除术的穿刺技术

目的 探讨前入路经腹L5／S1椎间盘髓核摘除术（TALD）的穿刺技术和方法。方法 尸体标本2具，解剖暴露L5／S1椎间盘前缘，用细针行多角度穿刺，探讨L5／S1椎间盘前路穿刺的进针方向。腰骶椎骨标本30套，摄片观察L5／S1椎间盘穿刺的影像标志。钡餐检查时，随机选取200例被检者，观测各骨性标志的显示率。TALD治疗L5／S1椎间盘脱出68例进行回顾。结果 TALD关键的步骤是穿刺针与腰骶间隙平行刺入椎间盘，必须确定皮肤进针点和椎间盘前缘进针点，椎间盘邻近的5个骨性标志对穿刺定位有重要帮助。结论 正确的穿刺方法对TALD的开展有重要意义。

Puncture technic of the transabdominal L5/S1 lumbar diskectomy

Objective To explore the puncture technic and method of the transabdominal L5/S1 lumbar diskectomy (TALD). Methods Two cases of cadaver were dissected and L5/S1 intervertebral disks were explored and punctured from different angles in order to probe the proper puncture angle for the needling. The radiographs of the lumbar and sacral vertabral samples of 30 cases were scrutinized and analysed to find the pancture imaging marks of the bones. When performing barium meal examinations, the lumbar and sacral spine of 200 cases were inspected to figure out the opacification of the rate imaging marks. 68 cases TALD were reviewed. Results The most pivotal process of the TALD is the needle puncture should be in parallel direction with lumbosacral interspace and then be pushed into the intervertebral disk. In order to make sure of the puncture point two sticking points should be fixed, on the abdomen and the another at the front edges of L5/S1 intervertebral disks. The five imaging makes of the lumbar, sacral, spine together with the neighboring L5/S1 intervertebral disks are of important help to find the front edges. Conclusion The correct puncture method is very important for performing TALD.