Chapter 1 Brief History of Spinal Endoscopic Surgery 1 1.1 History and Development of Unichannel Spinal Endoscopy 1 1.2 History of MED Technique 7 1.3 History of Bichannel Spinal Endoscopy 8 Chapter 2 Principles of V-Shape Bichannel Endoscopy System Design 15 2.1 Keypoints of V-Shape Bichannel Endoscopy System Design 18 2.2 Composition of V-Shape Bichannel Endoscopy System 19 2.2.1 V-Shape Channels 19 2.2.2 Spinal Endoscope 21 2.2.3 The Use of Trephine 21 2.2.4 The Lengthened Surgical Instruments 23 2.2.5 The Water Plugs 24 2.2.6 The Choice of Interbody Fusion Cages 24 2.2.7 Bone Graft Materials and Biological Factors 26 2.3 Foraminoplasty and Working Cannula Placement 26 2.4 Comparison of V-Shape Bichannel Endoscopy System and Conventional Unichannel Spinal Endoscopy Techniques 27 2.5 Comparison of V-Shape Bichannel Endoscopic Fusion and Unichannel Spinal Endoscopic Fusion 28 2.6 Comparison of V-Shape Bichannel Endoscopy System and Unilateral Biportal Endoscopy Techniques 29 Chapter 3 Clinical Applied Anatomy for V-Shape Bichannel Endoscopy 31 3.1 General Anatomy of the Lumbosacral Spine 31 3.1.1 Bone Structures of the Lumbosacral Spine 31 3.1.2 Connections Between Vertebrae 33 3.1.3 The Spinal Cord and Nerves of the Lumbosacral Spine 35 3.1.4 The Vascular Distribution in the Lumbosacral Spine 36 3.2 Anatomy Related to V-Shape Bichannel Endoscopy Surgical Approaches 39 3.2.1 Anatomy of the Lumbar Intervertebral Foramen 39 3.2.2 Anatomy of the Lumbar Facet Joint 42 3.2.3 The Safety Triangle 43 Chapter 4 V-Shape Bichannel Endoscopy Assisted Discectomy and Decompression 45 4.1 Application of Type I V-Shape Bichannel Endoscopy Decompression Cannula in Lumbar Surgery 46 4.1.1 Structure of Type I VBE Decompression Cannula 46 4.1.2 Indications 47 4.1.3 Instruments 47 4.1.4 Position 47 4.1.5 Planning 47 4.1.6 Anesthesia 48 4.1.7 Establishment of Working Channel for Unichannel Endoscope System 48 4.1.8 Establishment of Working Channel for Type I VBE Decompression Cannula 48 4.1.9 Foraminoplasty with Type I VBE Decompression Cannula 49 4.1.10 Discectomy and Decompression 50 4.2 Application of Type II V-Shape Bichannel Endoscopy Decompression Cannula in Lumbar Surgery 51 4.2.1 Structure of Type II VBE Decompression Cannula 51 4.2.2 Indications 51 4.2.3 Instruments 52 4.2.4 Position 52 4.2.5 Planning 52 4.2.6 Anesthesia 52 4.2.7 The Establishment of the Working Cannula 53 4.2.8 Discectomy and Decompression 53 Chapter 5 V-Shape Bichannel Endoscopic Lumbar Fusion 55 5.1 Anatomy 56 5.2 Surgical Instruments and Equipment 57 5.3 Layout of Operating Room 58 5.4 Surgical Indications 59 5.5 Surgical Contraindications 59 5.6 Surgical Methods 59 5.6.1 Preoperative Preparation and Planning 59 5.6.2 Body Position and Surface Location 60 5.6.3 Operation Process 62 5.7 Precautions for Operation 71 5.7.1 Preoperative Imaging Data Analysis and Surgical Planning 71 5.7.2 Direction of Puncture 71 5.7.3 Location of Working Cannula 71 5.7.4 How to Use a Trephine to Remove Bones? 72 5.7.5 Hemostasis 72 5.7.6 To Ensure the Fusion of Bone Graft 72 5.7.7 Use of Water Plug 72 5.7.8 Precautions of Decompression 73 5.7.9 Management of Working Cannula Shift 73 5.7.10 Avoidance of Vascular Injury 73 5.8 Postoperative Treatment 73 5.9 Prevention of Complications 73 5.9.1 Stimulation and Injury of the Outlet Root 73 5.9.2 Injury of Exiting Root and Dural Sac 74 5.9.3 Injury of Vessels and Organs in Front of Vertebral 74 5.9.4 Malposition of Interbody Fusion Cage 74 5.9.5 Nonunion of Bone Graft 74 Chapter 6 Clinical Application of V-Shape Bichannel Endoscopy 77 6.1 Application of V-Shape Bichannel Endoscopy in Lumbar Decompression 77 6.2 Application of V-Shape Bichannel Endoscopy in Lumbar Fusion 83 6.2.1 VBE Lumbar Fusion for Lumbar Spinal Stenosis 83 6.2.2 VBE Lumbar Fusion for Spondylolisthesis 99 6.3 VBE Lumbar Fusion for Lumbar Instability 107 6.4 VBE Lumbar Fusion for Recurrent Lumbar Disc Herniation 110 Chapter 7 Lumbar Surgery Rehabilitation 118 7.1 Introduction 118 7.2 Low Back Pain Clinical Practice Guideline 119 7.3 Preoperative Rehabilitation 121 7.4 Patient Education 125 7.5 Surgical Complications 125 7.6 Postoperative Evaluation 127 7.7 Postoperative Rehabilitation Principles 127 7.8 Postoperative Rehabilitation Protocols 130
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