脊椎微創手術

Minimally Invasive Spinal Surgery

脊椎手術傳統上是以所謂「開放性手術（open surgery）」執行，相對於其他外科領域，脊椎微創手術由於精密度高，所需器械昂貴和手術技巧養成費時等因素，發展較為緩慢。一般傳統脊椎手術缺點，主要有傷口大、組織破壞大且易造成椎節間不穩定等缺點。借由醫療影像診斷的進步，我們可以完成詳細的臨床評估，以小傷口（minimal incision）及極小的組織破壞（minimal invasive）達到治療病灶的目的。目前發展較為成熟的脊椎微創治療包括脊椎影像導引注射、椎間盤內電熱治療、經皮椎體成型術、顯微內視鏡椎間盤移除與椎弓減壓術、微創椎間融合術等等，臨床追蹤上都有不錯的治療效果。隨著科技不斷進步與手術者的經驗累積，脊椎微創手術的發展可能還有更多的突破。

The concept of minimally invasive spinal surgery embodies the goal of achieving clinical outcomes comparable to those of conventional open surgery, while minimizing the risk of iatrogenic injury that may be incurred during the exposure process. The development of new technology, such as microscopy, endoscopy and video and image guidance systems provided the foundation on which minimally invasive spinal surgery is based. Nowadays, well-developed and accepted minimally invasive spinal procedures includes image-guided injection technique, intradiskal electrothermal therapy, vertebroplasty and kyphoplasty, microendoscopic discectomy/laminectomy and mini-transforaminal interbody fusion. Further improvement in optics and imaging resources and introduction of instrumentation systems designed for minimally invasive procedures will inevitably lead to further applications in minimally invasive spine surgery