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Foraminal technique operation skills

Released on May. 17, 2022

Foraminal technique operation skills:

1. The technical operation of intervertebral foramina should emphasize the feeling of the mirror, that is, the feeling of the mirror. The feeling of the mirror plays a positioning role in the resolution of the direction of the surgical field of view, which directly affects the time and efficacy of the treatment.

Directions and techniques for using optical interface and lens: In the process of transforaminal surgery, sometimes the lens needs to be adjusted or rotated. After adjustment, pay attention to the direction of the lens, otherwise the surgical field of view will appear inverted, flipped, Mirror images and other illusions, causing visual differences. In some doctors without clinical puncture experience, there should be rich theory and important practice.

Second, the selection and use of the main mirror: the general main mirror has 0 ° and 30 °. Before doing treatment, be sure to look at the angle of the primary mirror. In this way, the treatment site can be accurately found during the operation. The image seen by the primary mirror at 0° is the surgical image directly in front of the working sleeve, which is more intuitive. The image seen by the 30° primary mirror is the image of the inclination plane of the working casing and the front. Therefore, a common problem during the operation is that the operator clearly sees the protrusion, but he can't get it with pliers. This is the reason.

3. Rotation and use skills of working casing:

①The directionality of the working sleeve, the side corresponding to the rotating handle on the working sleeve is the field of view with an inclination angle, and this surface is the image area we see on the monitor.

②Operation and rotation, in the process of posterior puncture, the front end of the inclination of the working sleeve should be close to the medial edge of the articular process, and slowly enter the spinal canal. After entering the spinal canal, the working sleeve should be rotated counterclockwise to make the inclination angle Facing the lateral articular process, this can safely protect the dural sac and avoid intraoperative damage to the dural sac.

During the posterolateral puncture, the front end of the inclined surface of the working sleeve should be as close to the upper articular surface of the next vertebral body as possible, and the inclined surface should face the direction of the lower articular surface of the upper vertebral body. To prevent the pain symptoms caused by the compression between the nerve branch and the vertebral body, facet process and the sleeve when the working sleeve is rotated.

Fourth, the use methods and skills of the disposable low-temperature plasma cutter head, the arc of the electrode and the curved treatment point should be mastered before use. The curved treatment point is on the opposite side of the handle, and should be mastered when using it.

5. Finally, pay attention to the angle and direction of the angled nucleus pulposus clamp. Usually on the opposite side of the handle is the forceps of the nucleus pulposus.