中德脊柱外科視頻會議

2024年8月9日，中德脊柱外科視頻會議於汕頭大學醫學院第一附屬醫院舉行。會議邀請德國慕尼黑哈拉興骨科醫院脊柱中心主任、歐洲脊柱學會（EUROSPINE）秘書長Siepe教授就脊柱微創手術相關問題進行演講。汕頭大學醫學院第一附屬醫院骨科胡軍教授致辭
，胡軍教授首先致謝Siepe教jiao授shou參can與yu此ci次ci在zai線xian學xue術shu會hui議yi，指zhi出chu附fu一yi院yuan骨gu科ke長chang期qi以yi來lai堅jian持chi學xue術shu交jiao流liu國guo際ji化hua，人ren才cai培pei養yang國guo際ji化hua
，帶dai動dong促cu進jin骨gu科ke學xue科ke發fa展zhan。骨gu科ke醫yi學xue研yan究jiu中zhong心xin許xu建jian坤kun副fu主zhu任ren及ji黃huang鍾zhong煉lian副fu主zhu任ren醫yi師shi共gong同tong主zhu持chi會hui議yi。Siepe教授以《全內鏡減壓手術中減壓不充分——原因及避免方法》作專題演講。Siepe教jiao授shou首shou先xian介jie紹shao脊ji柱zhu微wei創chuang手shou術shu的de發fa展zhan及ji其qi治zhi療liao退tui變bian性xing椎zhui管guan狹xia窄zhai的de優you勢shi，詳xiang細xi介jie紹shao如ru何he在zai內nei鏡jing下xia對dui退tui變bian性xing腰yao椎zhui管guan狹xia窄zhai進jin行xing充chong分fen減jian壓ya。教jiao授shou通tong過guo典dian型xing病bing例li，結jie合he手shou術shu視shi頻pin和he圖tu片pian，從cong手shou術shu適shi應ying證zheng、手術入路及手術器械使用等方麵細致講解全內鏡減壓手術的要點。Siepe教授指出，該手術最重要的是術者要通過肉眼觀察椎管和神經根是否得到直接、充chong分fen減jian壓ya，同tong時shi強qiang調tiao學xue習xi脊ji柱zhu內nei鏡jing手shou術shu是shi循xun序xu漸jian進jin的de
，鼓gu勵li年nian輕qing醫yi生sheng從cong簡jian單dan的de病bing例li入ru手shou

，逐zhu步bu熟shu練lian掌zhang握wo內nei鏡jing技ji術shu。分fen享xiang結jie束shu後hou，參can會hui者zhe與yuSiepe教授就脊柱穩定性與減壓之平衡
、年齡因素
、非(fei)退(tui)變(bian)性(xing)疾(ji)病(bing)的(de)內(nei)鏡(jing)適(shi)應(ying)證(zheng)和(he)禁(jin)忌(ji)證(zheng)等(deng)相(xiang)關(guan)問(wen)題(ti)進(jin)行(xing)了(le)一(yi)係(xi)列(lie)的(de)深(shen)入(ru)討(tao)論(lun)。汕(shan)頭(tou)大(da)學(xue)醫(yi)學(xue)院(yuan)第(di)一(yi)附(fu)屬(shu)醫(yi)院(yuan)骨(gu)科(ke)黃(huang)鍾(zhong)煉(lian)副(fu)主(zhu)任(ren)醫(yi)師(shi)分(fen)享(xiang)了(le)一(yi)例(li)腰(yao)椎(zhui)間(jian)盤(pan)突(tu)出(chu)症(zheng)導(dao)致(zhi)急(ji)性(xing)神(shen)經(jing)根(gen)功(gong)能(neng)障(zhang)礙(ai)的(de)病(bing)例(li)，並(bing)與(yu)Siepe教授就手術術式和入路展開討論。針對此類急性患者，Siepe教(jiao)授(shou)建(jian)議(yi)先(xian)解(jie)除(chu)椎(zhui)間(jian)盤(pan)突(tu)出(chu)對(dui)神(shen)經(jing)的(de)壓(ya)迫(po)
，避(bi)免(mian)神(shen)經(jing)損(sun)害(hai)進(jin)一(yi)步(bu)加(jia)重(zhong)導(dao)致(zhi)馬(ma)尾(wei)綜(zong)合(he)征(zheng)，術(shu)後(hou)再(zai)根(gen)據(ju)患(huan)者(zhe)情(qing)況(kuang)決(jue)定(ding)是(shi)否(fou)二(er)次(ci)手(shou)術(shu)。黃(huang)鍾(zhong)煉(lian)副(fu)主(zhu)任(ren)醫(yi)師(shi)對(dui)該(gai)患(huan)者(zhe)的(de)治(zhi)療(liao)方(fang)案(an)與(yu)Siepe教授一致，為患者進行了單側雙通道內鏡下髓核摘除術
，術後患者效果滿意。Siepe教授對該病例的處理表示讚同，指出該病例同時存在在慢性退變的基礎上出現急性症狀，診療具有非常重要的臨床意義。最後，Siepe教授感謝胡軍教授及其團隊的邀請，期待未來有更多機會進行學術交流。

On August 9th, 2024, Sino-German Video Conference on Spine Surgery was held at the First Affiliated Hospital of Shantou University Medical College.Prof. Siepe, Head of Spine Center of Schön Klinik München Harlaching and Secretary General of EUROSPINE, was invited to give a lecture on minimally invasive spine surgery.Prof. HU Jun, Director of the Dept. of Orthopedics of the First Affiliated Hospital of Shantou University Medical College, addressed an opening speech. He first thanked Prof. Siepe for attending the conference online, and said that the Dept. of Orthopedics of the hospital has been adhering to internationalization of academic exchange and talent cultivation so as to promote the development of orthopedic specialty.Deputy Directors XU Jiankun and HUANG Zhonglian of Orthopedics Medical Research Center of the hospital jointly moderated the conference.Prof. Siepe delivered a special speech on "Insufficient Decompression during Full Endoscopic Decompression – Why and How to Avoid it".First, Prof. Siepe introduced the development of minimally invasive spine surgery and its advantages on treating degenerative spinal stenosis, then illustrated in detail how to perform sufficient decompression for degenerative lumbar spinal stenosis under endoscope.With typical cases, surgical videos and images, Prof. Siepe stressed key points of full endoscopic decompression in terms of surgical indications, approaches and manoeuvre of instruments.According to Prof. Siepe, the most essential part of the surgery is that surgeons should confirm with their eyes if the spinal canal and nerve root are decompressed directly and sufficiently.Also, he emphasized that surgeons should learn spinal endoscopic technique step by step, and encouraged young surgeons to start with easy cases and master the technique gradually.After Prof. Siepe's sharing, he and the audiences had in-depth discussions on balance of spinal stability and decompression, the influence of age on surgical plan, indications and contraindications of endoscopy for non-degenerative diseases, etc.Deputy Director HUANG Zhonglian of the Dept. of Orthopedics of the hospital shared a case of lumbar disc herniation which led to acute neurological defects, and discussed with Prof. Siepe on surgical methods and approaches.For patients with acute symptoms, Prof. Siepe recommended to first relieve the compression of disc herniation on nerve roots to avoid the progression of neurological defects which could progress into cauda equina syndrome, then to decide if a second surgery is needed based on patients' postoperative condition.Deputy Director HUANG Zhonglian had chosen the same surgical plan as Prof. Siepe suggested, performing a discectomy with UBE for the patient. And the patient was happy after the surgery.Prof. Siepe appreciated his solution and case sharing, for the case is featured with chronic degeneration as well as acute symptoms and has significant value for clinical diagnosis and treatment.At last, Prof. Siepe thanked for the invitation from Prof. HU Jun and his team, and looked forward to more opportunities for academic exchanges in the future.