显微镜辅助手术治疗腰椎退行性疾病腰椎退变性疾病的手术治疗减压：◦椎间盘、骨赘、小关节、黄韧带..固定、融合恢复脊柱的排列神经减压时使用放大镜/ 显微镜◦充分、精细、安全减压◦精确止血◦修补硬膜椎间盘切除术◦椎板间开窗◦经椎板入路髓核摘除术◦极外侧型椎间盘突出髓核摘除术腰椎管狭窄症的减压其他：微创前路手术 etc…显微镜在腰椎退行性疾病手术中的应用microdiscectomyMicrodiscectomy 仍然是治疗腰椎间盘突出症手术的“金标准” Lumbar disc herniation1st floor2nd floor3rd floorMcCulloch JA (1998)Trans-laminar approachCPP, F 43L3/4 椎间盘突出症Trans-laminar apporachJHJ ，M 31yoL3/4 极外侧型椎间盘突出症Post-op X-ray单侧入路双侧减压1988 年，Young 首先提出通过单侧入路可充分解除硬膜囊和双侧神经根的压迫同侧：椎间盘突出、小关节增生、肥厚黄韧带对侧：小关节增生、肥厚黄韧带，椎间盘突出？腰椎管狭窄症的显微减压WLD, F 74L3/4, L4/5 椎管狭窄症，L4/5 节段不稳L3/4L4/5L5/S1Four pillars of MISSMinimally Invasive Spine Surgery: Techniques, Evidence and ControversiesAccess :•Tubular•Mini-openMicrosurgery:•Microscope •EndoscopeImage & navigation•2D•3DSpecial instrument•Percutaneous•Mini-open应用显微镜的优点—同轴照明Magnification 放大Source: Prof. Mayer, SchoenklinikenErgonomics 人体工程学SRS 44th Annual Meeting 2009 Paper #52Musculoskeletal Injuries Among Spine Surgeons: Results of a Survey of the SRSMembershipJoshua D. Auerbach, MD; Zachary D. Weidner, BA; Andrew H. Milby, BS; Mohammad Diab, MD; Baron S. Lonner, MD (NYU Hospital for Joint Diseases)Conclusion: …. in our cohort, spine surgeons underwent surgical intervention for lumbar disc disease (7.1%) and cervical disc disease (4.6%) at rates that far exceed disease estimates in the general population…Sharing the View 视野分享小结手术显微镜具有放大、照明等优点，对于神经等结构辨认更清楚，手术操作更精准精细显微镜辅助手术治疗腰椎退行性疾病可明显减少切口大小，减少软组织损伤，减少出血和术后病痛，达到微创手术的目的学习曲线和专业技术培训
