Recently, the orthopedic spine team of Beijing Tiantan Hospital successfully carried out the first arthroscopic assisted single-hole endoscopy (AUSS) surgery, successfully performing minimally invasive nucleus pulposterior removal surgery on a taxi driver suffering from lumbar disc herniation, which relieves the compression of the nerve roots.

This is another spinal microinnovation technology completed by the hospital's orthopedic spinal team after the hospital's orthopedic spinal team carried out intervertebral foraminioscopic surgery and unilateral dual-channel spinal endoscopic surgery, marking a new level of minimally invasive spinal diagnosis and treatment level in the hospital.

Mr. Chen, 45 years old this year, is a taxi driver. Due to his long-term sitting and driving habits, the symptoms of lumbar leg pain have repeatedly and intermittently attacked. It has been more than two years since he was diagnosed with lumbar disc herniation. Out of fear of the traditional "surgery" lumbar disc herniation surgical plan, he has been relieved through conservative treatment plans, and the condition has been repeated. Recently, Mr. Chen's symptoms have been frequent and significantly worse than before. His waist pain is unbearable and he has curvature. In severe cases, he cannot straighten his waist at all. At the same time, he has severe symptoms of radioactive pain and numbness in the left lower limb. Sometimes it is very difficult to walk, which seriously affects normal movement and life.

Mr. Chen, who was suffering from the pain, went to many hospitals for treatment, but his condition has never been effectively relieved. A month ago, he came to the orthopedic department of Beijing Tiantan Hospital for treatment. After receiving the treatment, Chief Physician Judy of Orthopedics, he prescribed relevant examinations for him after detailed consultation and physical examination.

The results of lumbar spine MRI show that the discs of Mr. Chen’s 4th and 5th lumbar spine were severely herniated, and the nucleus pulposus prolapsed into the spinal canal, which had compressed the nerve root and needed surgical treatment. Before admission, Mr. Chen was still very worried: Is there any surgical method that does not perform a major surgery and minimally invasive treatment of lumbar disc herniation?

Regarding Mr. Chen's condition, Director Liu Baoge of Orthopedics organized a spinal team to conduct case analysis and preoperative discussion after rounds. Finally, he decided to use the new arthroscopic-assisted single-hole spinal endoscopy technology to treat according to the treatment concept of "individualization, precision, and minimally invasiveness".

"This surgical method not only has the advantages of minimally invasiveness of intervertebral foraminioscopic soft tissue damage, but also has the characteristics of flexible operation and high pressure reduction efficiency of dual-channel endoscopic surgery." Director Liu Baoge introduced, "This allows patients to move underground earlier, reduce the occurrence of complications, and shorten the postoperative recovery time as much as possible.

After improving the preoperative preparation, with the strong cooperation of the anesthesia department and the operating room, the chief physician of orthopedics Zhu Di and Wang Lei were successfully removed from the lumbar disc nucleus pulposus that compressed the nerve root for Mr. Chen in just about an hour. The entire operation was completed under the clear and enlarged visual monitoring of the endoscopic observation. The incision at the surgical site was only 1.5 cm in size, achieving the expected effect of less bleeding, less peeling and high efficiency.

The operation was smooth, and the symptoms of low back pain and lower limbs were immediately relieved. You could get out of bed and move around the next day, and the symptoms of discomfort before the operation almost completely disappeared. He was discharged from the hospital in just three days.

According to Dr. Judy, as our country gradually enters a deeply aging society, the incidence of spinal degenerative diseases has been increasing year by year, becoming a major health problem that plagues middle-aged and elderly people. Among them, lumbar disc herniation, lumbar spinal stenosis, cervical spondylosis and other diseases are particularly common, which brings great inconvenience and pain to patients' lives.

Clinically, surgery is often the "last choice" for spinal diseases that are ineffective in conservative treatment. With the rapid development of minimally invasive technology, minimally invasive spinal technology represented by spinal endoscopy and spinal microscopy technology has been widely used in clinical practice and has achieved satisfactory therapeutic effects.

Compared with traditional open surgery, minimally invasive surgical technology has less damage to the paravertebral muscles of the spine, which can preserve the complete spinal structure to the greatest extent and maintain the stability of the spine after surgery. It has the advantages of small trauma, fewer bleeding, quick recovery, fewer complications, and accurate efficacy. With the development of treatment concepts, surgical technology and medical devices, minimally invasive spinal technology has become a booming trend in the country. (Judy, Department of Orthopedics of Beijing Tiantan Hospital Affiliated to Capital Medical University)

[Editor in charge: Wang Yuqi]