Suzukawa M, Abe Y, Chinzei T, Yonezawa T, Kouno A, Ono T, Niwa S, Sogawa I, Mabuchi K, Imachi K
Institute of Medical Electronics, University of Tokyo, Japan.
J Clin Laser Med Surg. 1990 Dec;8(6):27-30. doi: 10.1089/clm.1990.8.27.
For percutaneous observation of lesions near the spinal cord and percutaneous spinal laser surgery under the visual field, we studied a method and approach to the spinal cord and intraspinal surgical procedures with laser using a newly developed, small-diameter laser endoscope. The subarachnoid and epidural spaces of a goat were punctured using a 17-gauge epidural needle, and the endoscope (diameter 0.7 mm) was inserted through the needle. The spinal cord and surrounding tissue were observed. Next, an endoscope (diameter 1.5 mm) was inserted into the subarachnoid space, and the quality of the picture and manageability of the endoscope were examined. The Xe:Cl excimer laser was irradiated to a nerve root through a 0.4 mm optical fiber for laser transmission through this endoscope. The spinal cord, nerve roots, and arachnoid were clearly observed through this endoscope. The pulsation of the artery accompanying a root was seen clearly, and the quality of the picture of the endoscope was thought to be sufficient for diagnosis. The nerve root was cut within 30 seconds by excimer laser, and the possibility of laser surgery was demonstrated. Although it was shown that this endoscope could be a useful diagnostic and therapeutic tool, improvement in the manageability of the tip of the endoscope was considered to be important for a clinically usable endoscope.
为了经皮观察脊髓附近的病变以及在视野下进行经皮脊髓激光手术，我们使用新开发的小直径激光内窥镜研究了一种针对脊髓及脊髓内手术操作的方法和途径。使用17号硬膜外穿刺针穿刺山羊的蛛网膜下腔和硬膜外间隙，然后将内窥镜（直径0.7毫米）通过该穿刺针插入。对脊髓及周围组织进行观察。接下来，将直径1.5毫米的内窥镜插入蛛网膜下腔，并检查图像质量和内窥镜的可操作性。通过一根0.4毫米的光纤将Xe:Cl准分子激光经此内窥镜照射到神经根上。通过该内窥镜可以清晰地观察到脊髓、神经根和蛛网膜。能清楚地看到伴行于神经根的动脉搏动，并且认为内窥镜的图像质量足以用于诊断。准分子激光在30秒内切断了神经根，证明了激光手术的可能性。虽然已表明这种内窥镜可能是一种有用的诊断和治疗工具，但对于临床可用的内窥镜而言，提高内窥镜尖端的可操作性被认为是很重要的。
