中德脊柱外科视频会议

2024年8月9日，中德脊柱外科视频会议于汕头大学医学院第一附属医院举行。会议邀请德国慕尼黑哈拉兴骨科医院脊柱中心主任、欧洲脊柱学会（EUROSPINE）秘书长Siepe教授就脊柱微创手术相关问题进行演讲。汕头大学医学院第一附属医院骨科胡军教授致辞，胡军教授首先致谢Siepe教授参与此次在线学术会议，指出附一院骨科长期以来坚持学术交流国际化，人才培养国际化，带动促进骨科学科发展。骨科医学研究中心许建坤副主任及黄钟炼副主任医师共同主持会议。Siepe教授以《全内镜减压手术中减压不充分——原因及避免方法》作专题演讲。Siepe教授首先介绍脊柱微创手术的发展及其治疗退变性椎管狭窄的优势，详细介绍如何在内镜下对退变性腰椎管狭窄进行充分减压。教授通过典型病例，结合手术视频和图片，从手术适应证、手术入路及手术器械使用等方面细致讲解全内镜减压手术的要点。Siepe教授指出，该手术最重要的是术者要通过肉眼观察椎管和神经根是否得到直接、充分减压，同时强调学习脊柱内镜手术是循序渐进的，鼓励年轻医生从简单的病例入手，逐步熟练掌握内镜技术。分享结束后，参会者与Siepe教授就脊柱稳定性与减压之平衡、年龄因素、非退变性疾病的内镜适应证和禁忌证等相关问题进行了一系列的深入讨论。汕头大学医学院第一附属医院骨科黄钟炼副主任医师分享了一例腰椎间盘突出症导致急性神经根功能障碍的病例，并与Siepe教授就手术术式和入路展开讨论。针对此类急性患者，Siepe教授建议先解除椎间盘突出对神经的压迫，避免神经损害进一步加重导致马尾综合征，术后再根据患者情况决定是否二次手术。黄钟炼副主任医师对该患者的治疗方案与Siepe教授一致，为患者进行了单侧双通道内镜下髓核摘除术，术后患者效果满意。Siepe教授对该病例的处理表示赞同，指出该病例同时存在在慢性退变的基础上出现急性症状，诊疗具有非常重要的临床意义。最后，Siepe教授感谢胡军教授及其团队的邀请，期待未来有更多机会进行学术交流。

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.