https://radiologykey.com/essential- khoom siv- xuas nrig ntaus- koob/

Lumbarxuas nrig ntausstands raws li ib tug pivotal diagnostic thiab kho cov txheej txheem nyob rau hauv neurology, anesthesiology thiab kev tswj qhov mob. Kev nruam txuas ntxiv hauv cov koob txhaj tshuaj yog ib lub hauv paus rau kev nyab xeeb thiab ua tiav cov txheej txheem lumbar puncture. Cov keeb kwm kev loj hlob ntawm lumbar puncture koob epitomizes hloov los ntawm empiric dig muag puncture tshuaj rau cov duab -coj precision tshuaj.

Thaum ntxov- tiam lumbar puncture koob muaj ib tug rudimentary hollow steel bevel -tipped configuration, engineered feem ntau los tsim ib tug yam ntxwv "pop" hnov ​​thaum tho lub ligamentum flavum thiab pab cerebrospinal kua (CSF) aspiration. Cov txheej txheem no hnyav heev ntawm cov kws kho mob 'tactile rhiab heev thiab kev ua tau zoo. Thaum tswj cov neeg mob rog, cov neeg uas muaj tus txha caj qaum deformities, cov neeg laus uas muaj calcified spinal ligaments, los yog cov neeg mob uas muaj distorted anatomical architecture thib ob rau kev phais tus txha caj qaum, xws li cov pa koob tau txais txiaj ntsig zoo siab qhov tsis ua hauj lwm thiab muaj kev pheej hmoo siab dua ntawm cov teeb meem tsis zoo nrog rau cov kev raug mob ntawm lub cev thiab kev puas tsuaj rau lub paj hlwb.

Ib qho kev paub txog kev siv technology tau tuaj txog nrog kev siv dav dav ntawm atraumatic mem hluav -point lumbar puncture koob. Cov koob beveled ib txwm sever dural fibers ntau dua li sib cais lawv thaum taug kev dura mater, ua rau muaj qhov tsis xws luag dural uas ua rau muaj kev pheej hmoo tom qab CSF to - thawj qhov ua txhaum tom qab - mob taub hau dural (PDPH). Pencil-cov koob taw tes xws li Whitacre thiab Sprotte koob khav theeb blunt mem hluav- zoo li lub taub hau nrog rau sab orifices, uas bluntly dissect dural fibers sib nrug thiab txo qhov loj ntawm dural lacerations. Qhov kev tsim no txo ​​qis qhov tshwm sim ntawm PDPH los ntawm kwv yees li 30% mus rau 1% -2%, ua rau cov neeg mob muaj kev nplij siab thiab ua kom muaj txiaj ntsig zoo ntawm kev cuam tshuam tsawg kawg nkaus.

Txiav-txoj kev vam meej niaj hnub no nyob rau hauv kev sib koom ua ke ntawm cov koob txhaj tshuaj nrog lub sijhawm tiag tiag - duab navigation thev naus laus zis. Qhov muag tsis pom kev vam khom tsuas yog nyob rau sab saum toj anatomical landmarks yog hloov zuj zus los ntawm tiag tiag - lub sij hawm ultrasound kev taw qhia. Ua ntej- cov txheej txheem ultrasound precisely pinpoints lub hom phiaj intervertebral chaw, midline landmarks, insertion angles thiab puncture tob; intraoperative tiag tiag- lub sij hawm ultrasound dynamically taug qab koob tip trajectory kom paub meej tias qhov chaw nyob hauv qhov chaw subarachnoid. Qhov kev hloov pauv no ua pov thawj tshwj xeeb tshwj xeeb rau cov neeg mob anatomically nyuaj thiab cov neeg uas muaj lub cev tsis zoo, hloov pauv tactile- nyob ntawm qhov muag tsis pom kev ua kom pom tseeb - tau txais kev cuam tshuam meej. Tsis tas li ntawd, cov koob siv tau nrog cov paj hlwb peripheral stimulators ua rau thaj chaw ntawm koob cov lus qhia uas nyob ib sab ntawm cov paj hlwb txha caj qaum los ntawm kev tshem tawm cov lus teb rau cov leeg nqaij, ntxiv ib txheej ntxiv ntawm kev nyab xeeb rau kev mob thiab cov txheej txheem peripheral hlab ntsha.

Tsiv mus tom ntej, lumbar puncture koob yuav hloov zuj zus mus rau qhov kev txawj ntse thiab kev sib xyaw ua ke. Novel designs incorporating miniaturized pressure transducers enables instantaneous confirmation of subarachnoid chaw nkag ntawm nyob rau hauv -situ siab xyuas; koob cov lus qhia ua ke nrog kho qhov muag coherence tomography (OCT) tuaj yeem tso cai tiag tiag -lub sijhawm pom kev ntawm microstructural nta ntawm tus txha caj qaum. Hauv paus, qhov kev hloov pauv hloov pauv ntawm lumbar puncture koob sawv cev rau kev txo qis ntawm kev tawm tsam, txhim kho qhov tseeb thiab txhim kho cov txheej txheem kev nyab xeeb rau kev kho mob hnyav. Tshaj li qhov kev nce qib hauv kev nce qib, qhov kev hloov pauv no tsom mus rau kev kho kom zoo ntawm kev kho mob lub tswv yim los ntawm empirical, kev tswj xyuas nruj rau kev saib xyuas tus kheej kom zoo, thaum kawg ua rau cov neeg mob tau txais kev kuaj mob thiab kev kho mob nrog cov txheej txheem kev pheej hmoo tsawg.