CT引导下脊柱微创手术技术在诊治脊柱疾病中的应用

目的：研究CT引导下经皮微创手术在诊治各种脊柱疾病中的应用。方法；对1997年7月至2002年2月在CT引导下微创手术诊断和治疗的138例患者的临床资料进行回顾性分析。其中诊断性手术53例；治疗性手术85例，包括骶神经根囊肿穿刺医用生物蛋白胶注入术55例，脊柱结核及椎间隙感染病灶清除灌注冲洗术30例，结果：诊断性手术中，骨肿瘤和肿瘤骨转移28例，炎症和良性病变25例，首次确诊率为98.6%，恶性肿瘤没有发生活检通道种植转移。治疗性手术没有发生术中和术后并发症，没有出现窑道和伤口不愈，随访8个月-4年，经过治疗的骶神经根囊肿呈现皱缩，纤维化；脊柱结核及椎间隙感染患者，未进行二次手术。结论：CT引导下经皮微创手术技术在诊断上可以获得足量的标本进行常规病理和免疫组化检查，治疗上对早中期脊柱结核和椎间隙感染可以取代切开手术，对骶神经根囊肿的治疗可经一次注射治疗成功，是一种非常安全有效的治疗方法。

CT-guided percutaneous minimal invasion surgery for diagnosis and treatment of spinal disease

Objective:To investigate the feasibility of CT-guided percutaneous minimal invasion surgery for diagnosis and treatment of spinal diseases.Method:138 cases of CT-guided percutaneous minimal invasion surgery biopsies and treatment performed between 1997-2002 were reported.Diagnostic operations were 53 cases.Treatment operations were 85 cases.That included sacral meningeal cysts 55 cases which were injected with fibrin sealant,spinal tuberculosis and interspace infection 30 cases which were treated with persistant local chemotherapy and irrigation.Result:In diagnostic operations,skeletal tumor and metastatic carcinoma were found in 28 cases.Skeletal infection and benign changes were detected in 25 cases.In treatment operations,there was no complication.Sinus and nonunion did not occured.Following-up 8 months to 4 years on sacral meningeal cysts showed shrinkage and fibrosis.All spinal tuberculosis and interspace infecton did no secondary operation.Conclusion:CT-guided percutaneous minimal invasion surgery can get enough sample for pathological diagnosis and immunohistological examination.Minimal invasive surgery for primary or metaphase spinal tuberculosis could replace incision operation.Fibrin sealant injection was an one time treatment and a safe method for sacral meningeal cysts.