微通道显微镜手术在脊柱脊髓疾病中的应用

Application of Microscopic Microchannel Surgery in Spinal and Spinal Cord Diseases

摘要: 脊柱脊髓疾病作为全球重大健康负担，其后遗症高风险与复杂治疗需求推动了微创技术的发展。微通道显微镜手术(Microscopic Microchannel Surgery, MMS)通过结合微创通道技术与显微成像系统，实现了精准、低创伤的脊柱外科干预。本文系统描述了微通道显微镜手术在脊柱退行性疾病(如腰椎间盘突出、椎管狭窄)及椎管内肿瘤治疗中的应用，重点剖析其技术原理、临床优势与局限性。研究表明，微通道显微镜手术通过小切口与逐级扩张通道，显著减少术中组织损伤与术后并发症，尤其适用于老年患者及高风险人群；在颈椎病领域，改良术式(如AMTc、AETc)进一步拓展了其适应症，兼顾生物力学保留与病变精准切除。尽管微通道显微镜手术在腰椎与椎管肿瘤治疗中表现出与开放手术相当的疗效，但其技术门槛高、操作空间有限等问题仍需突破。未来研究应聚焦适应症扩展、脊柱稳定性及长期疗效验证，以推动脊柱微创外科的精准化与个体化发展。

Abstract: Spinal and spinal cord diseases are a significant global health burden. The high risk of sequelae and complex treatment requirements have driven the development of minimally invasive techniques. Microscopic Microchannel Surgery (MMS), which combines minimally invasive channel technology with a microimaging system, has enabled precise and minimally traumatic spinal interventions. This article systematically describes the application of MMS in the treatment of spinal degenerative diseases (such as lumbar disc herniation and spinal canal stenosis) and intradural tumors, with a focus on its technical principles, clinical advantages, and limitations. Studies have shown that MMS, through small incisions and gradual expansion of the channel, significantly reduces intraoperative tissue damage and postoperative complications, making it particularly suitable for elderly patients and high-risk populations. In the field of cervical spondylosis, modified surgical procedures (such as AMTc and AETc) have further expanded its indications, balancing the retention of biomechanics and precise removal of lesions. Although MMS has demonstrated comparable efficacy to open surgery in the treatment of lumbar and intradural tumors, its high technical threshold and limited operating space still need to be overcome. Future research should focus on expanding indications, verifying spinal stability, and long-term efficacy to promote the precision and individualization of minimally invasive spinal surgery.