HKAH Spine Center Booklet

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电司席
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1 Minimally Invasive pine Surgery Center 脊椎微創手術中心 At MISS, our expert team is dedicated to making every spine patient's story a successful one. 全心關注, 以專業譜寫脊椎病人健康故事新一頁 Minimally Invasive Spine Surgery Center Tel: (852) (by appointment) [email protected] Address: Hong Kong Adventist Hospital 40 Stubbs Road, Hong Kong Website: 脊椎微創手術中心電話 :(852) ( 敬請預約 ) 電郵 :[email protected] 地址 : 香港司徒拔道 40 號香港港安醫院網址 :

2 A Single Stop for Spine Care 一站式脊椎護理 The Minimally Invasive Spine Surgery (MISS) Center offers a multidisciplinary spine program led by highly trained neurosurgeons, anaesthesiologists, radiologists, peri-operative nurses, radiographers, and physiotherapists. Providing comprehensive, quality care for patients suffering from spinal disorders, our professional team is committed to advancing new therapies to eliminate pain, restore function, and improve quality of life. 香港港安醫院的脊椎微創手術中心匯聚神經外科專科醫生麻醉科專科醫生放射科專科醫生手術專科護士放射技師和物理治療師, 為受脊椎問題困擾的人士帶來全面而優質的脊椎護理這些專家對脊椎治療的經驗豐富, 加上我們的專業護理團隊, 將為大家帶來各種最先進的治療方法, 以紓緩痛楚, 幫助恢復活動能力, 並提高生活質素 Accurate diagnosis 精確診斷 By taking the time to listen and gain a full background of each case, we are able to perform a comprehensive evaluation using the most technologically advanced 3T magnetic resonance imaging (MRI) scan, which yields a highly accurate diagnosis. 準確判斷病情對治療脊椎問題尤其重要, 我們的醫生會耐心聆聽, 詳細了解每位病人的情況和困擾, 並且利用最先進的 3T 磁力共振來作全面而透徹的評估 Excellent information on available options 幫助了解不同治療方案 An accurate diagnosis ensures that the most suitable treatment is selected, which may not always involve surgery. Patients are thoroughly informed about their options so that they may make the best decision possible. 診斷精確, 才能建議最合適而有效的治療方案, 而手術往往並非唯一選擇我們會盡力提供詳盡資訊, 好讓病人清楚了解各種治療方法的可行性, 以作出最佳決定 State-of-the-art surgical services 先進介入治療 Technologically advanced operating rooms dedicated to injections and operations, as well as a wide variety of surgical modalities are available, depending on each patient's specific needs. 手術室配備了各種高科技的設備和儀器, 能夠因應個別人士的需要, 支援多種外科治療, 包括注射傳統開刀和微創等 1 2

3 Spine System for the Operating Table 脊椎手術固定系統 This system can be attached to the operating room table to improve the positioning of patients for spine surgeries as well as C-arm imaging. 這系統可加裝於手術枱上, 幫助固定病人的姿勢和位置, 並提高 C 型臂 X 光儀的準確性 State-of-the-art Operating Rooms 手術室設備精良 Hong Kong Adventist Hospital's operation rooms feature two integrated operating room systems, the Karl Storz OR1 and the Olympus endoalpha. They also boast advanced minimally invasive spine instruments for various minimally invasive procedures. Under the care of our experienced and helpful surgical team and medical staff, patients can rest assured that they will be receiving the best examinations and treatment. 香港港安醫院手術室設有兩套一體化手術室系統,Karl Storz OR1 和 Olympus endoalpha, 配合多款先進的脊椎微創手術儀器, 以應付各種微創手術醫療團隊經驗豐富且細心周到, 務求提供卓越的檢查和治療 Operating Microscope 手術顯微鏡 The system is vibration-free at all magnification levels. With outstand contrast, brilliance, sharpness resolution, color fidelity, and precision, it offers innovative illumination solutions for the spine surgeon's convenience and patient's safety. 這款手術顯微鏡能清楚放大手術區域, 影像不僅不會出現震動, 而且對比明確清晰精細和傳真, 讓手術能安全和準確地施行, 進一步保障病人的安全 3 4

4 Spotlight Access System 聚光引入系統 Through the positioning of the port down to the lamina and superior lighting capabilities, this system provides adequate lighting of the operative site at the depth of the wound. 這系統照明功能極其卓越, 加上特別的設計令它可以深入脊板位置, 為手術區域提供充足的照明, 令每個部位都清楚顯露 Minimally Invasive Spine Surgery 脊椎微創手術 Minimally invasive surgery is available for a number of spinal disorders, ranging from degenerative diseases to spinal tumors. State-of-the-art instrumentation designed specifically for these procedures allow for improved visualization and mobility. Our specialists have extensive training and experience in non-surgical and surgical treatments, as well as minimally invasive spinal techniques, which have the potential to greatly benefit patients. 醫療技術和儀器發展迅速, 現在已能夠使用微創方式來治療脊椎退化以至腫瘤等一系列的脊椎病變所使用的儀器乃專門為微創手術而設計, 可以令影像更清晣, 手術更精細和準確我們的醫療團隊不但專業, 且對治療各種脊椎問題均經驗豐富, 結合高科技儀器, 可以為脊椎病人提供手術和非手術治療, 包括各種介入治療和微創手術 METRx II System METRx II 系統 This system provides spine surgeons with excellent visualization of the operative field. The tubular retractors split rather than cut through the muscles, thereby causing much less tissue trauma and post-operative pain to the patient compared with conventional surgery. 利用這管狀引導器, 可以於手術時分隔而非切斷肌肉, 既能夠讓醫生清楚看到手術區域與傳統手術比較, 有助減低對病人身體組織的傷害, 減輕手術後的痛楚 Quicker recovery 復原較快 Shorter hospitalization 住院時間較短 Less post-operative pain 減少手術後的痛楚 Small incisions 傷口較細 Advantages of MISS 脊椎微創手術的優點 Less blood loss 失血較少 Small surgical scars 手術疤痕較細 Lower infection rate 降低感染機會 Less trauma to the body 減少手術帶來的創傷 5 6

5 Common Spine Problems 常見的脊椎問題 Neck (Cervical) 頸 ( 頸椎 ) Sprained neck 頸椎扭傷 ( 俗稱瞓厲頸 ) Cervical degenerative disc disease 頸椎椎間盤退化 Cervical radicalopathy 頸椎根神經病變 Cervical myelopathy 頸椎脊髓病變 Cervical facet joint pain 頸椎小關節疼痛 Atlantoaxial instability (C1-2 spine) 寰椎樞椎關節不穩定 ( 第 1 至 2 節頸椎 ) Cervical kyphotic deformity 頸椎後突畸形 Spinal Injection and Intradiscal Therapies 脊椎注射及椎間盤治療 Cervical facet joint injection Cervical epidural injection Cervical nerve root block Lumbar transforaminal epidural injection Lumbar selective nerve root block Lumbar facet joint block Caudal epidural injection Lumbar discography Sacroiliac joint block Radiofrequency lesioning procedures Intradiscal therapies Biaculoplasty Plasma coblation nucleoplasty Intradiscal electrothermal therapy (IDET) 頸椎小關節注射頸椎硬膜外注射頸神經根阻隔術腰椎間孔硬膜外注射局部腰椎神經根阻隔術腰椎小關節阻隔術骶管硬膜外注射腰椎椎間盤造影薦髂關節阻隔術射頻治療 ( 射頻燒灼術 ) 椎間盤治療椎間盤射頻熱凝法低溫等離子消融髓核成形椎間盤內電熱療法 Lower Back (Lumbar) 腰背部腰椎 ( ) A variety of advanced, minimally invasive techniques are available to treat conditions of the lumbar spine. Sprained back 隨着技術發展, 腰椎問題已可以微創方式治療背部扭傷 Lumbar disc prolapse 腰椎椎間盤突出 Sciatica 坐骨神經痛 Lumbar stenosis 腰椎管狹窄症 Lumbar facet joint pain 腰椎小關節疼痛 Lumbar spine spondylolisthesis 腰椎滑脫 Lumbar discogenic pain 腰椎盤源性腰痛 Osteoporotic fracture 骨質疏鬆性骨折 Lumbar degenerative scoliosis 腰椎退變性側突 7 8

6 Minimally Invasive Surgical Procedures 脊椎微創手術 Cervical artifical disc replacement Microscopic discectomy Cervical foraminotomy Laminectomy / laminotomy Transforaminal lumbar interbody fusion (TLIF) / extreme lateral interbody fusion (XLIF) / direct lateral lumbar interbody fusion (DLIF) / oblique lumbar interbody fusion (OLIF) Percutaneous pedicle screw fixation Percutaneous facet screw fixation Vertebroplasty / kyphoplasty Interspinous stabilization 頸椎人工椎間盤置換術顯微椎間盤切除術頸椎椎間孔切開術椎板切除術 / 椎板開孔術經椎間孔腰椎椎間融合術 / 極外側椎間融合術 / 直接外側腰椎椎間融合術 / 斜向腰椎椎間融合術經皮椎弓根螺釘內固定術經皮小關節骨釘固定術椎體成形術 / 後突椎體成形術椎間穩定術 Using specialized tubular retractors and endoscopes to move through tiny incisions, surgeons are able to treat cervical spine disorders with minimally invasive surgery. 利用特製的管狀引導器和內視鏡, 醫生就可通過細小的傷口來進行微創手術, 治療各種頸椎問題 Rehabilitation plays an important part in helping patients ease their pain, restore the health and functional abilities of their spine, and acquire the best possible benefits from their spine surgery. Our highly skilled physiotherapists help patients return to their daily activities to enjoy a more active, healthy lifestyle. A well-structured conditioning program is customized to ensure that it is safe, effective, and most suitable to meet each patient s rehabilitation goals. 康復治療對脊椎治療尤其重要, 它能夠幫助病人紓緩痛楚, 恢復脊椎的活動能力和健康如需接受手術, 配合康復計劃, 還有助發揮最佳的治療效果我們的物理治療師專業而周到, 會根據個別情況設計合適的計劃, 務求令整個治療安全而有效, 好讓病人盡快回復日常生活, 甚至可以比過去更活躍和健康 Our physiotherapists work with patients through: 以下多項服務均有助脊椎病人康復 : Physiotherapy Rehabilitation Program Pain control 痛楚管理 One-on-one training 一對一訓練 Exercise for recovery and fitness 復康及健身運動 Education on: 教育資訊 : Anatomy of the spine 脊椎解剖學 Importance of good posture 良好姿勢的重要性 Safe body mechanics 安全的身體力學 Workstation ergonomics 工作間的人體工學物理治療康復計劃 9

第一章　緒論

第一章　緒論 (informed consent) 6 . (Informed 23 Consent) 24 (Informed Consent) informed consent 1. 2. 7 3. 4. 5. 6.. 26 1. 8 2. 3. 4. 5. 6.. Braddock 1993 59 65 1057 (discussion of the patient s role in decision making)