奇美醫引進「脊椎微創一次性手術工具」 降低感染及減輕術後疼痛 滿意度高達9成5
2023-03-07 記者 蘇旋/報導
35歲阿德,為一年輕男性,卻長期被背痛所苦,不僅影響正常工作,有時甚至痛到無法下床。阿德嘗試各種民俗療法及保守治療但都無法改善症狀,經朋友推薦至奇美醫學中心神經外科暨電腦刀中心主任王哲川門診就診。詳細檢查後發現背痛爲椎弓解離症併脊椎滑脫嚴重壓迫脊椎神經所導致,在與阿德討論治療方法後,決定選擇脊椎微創手術併一次性手術工具。手術後隔天可著背架下床活動,三天後疼痛指數明顯由9降至1,術後五天出院,手術住院期間均未出現手術部位感染,一個月後回到原職場(需負重)工作。目前已手術一年,均正常工作生活,並且無需背架使用。
奇美醫學中心神經外科暨電腦刀中心主任王哲川說明,脊椎微創手術已成為部分民眾脊椎手術的選擇之一,目前各種脊椎微創手術包括針孔般大小傷口、內視鏡脊椎微創手術、顯微鏡微創手術,以及需較大傷口的椎籠融合骨釘固定的脊椎微創手術。微創手術在脊椎領域上已發展幾十年,各種術式都有適合的疾病,但目標都是對於組織做最小的破壞達到解決病人病痛的目的。也就是正確的脊椎微創手術觀念不是追求外觀的小傷口,而是追求手術對組織的最小破壞。
王哲川指出,脊椎手術併發症之一的感染是每位外科醫師的夢魘,其造成的原因不外乎手術室的無菌技術,病人本身條件(多共病、免疫差)、手術時間長、術後傷口照顧等等。每位手術醫師都盡量讓這些因素降到最低,一旦發生病人可能須延長住院時間,整個醫療費用提高,延後病人回職場的計畫,甚至需再次手術移除骨釘等。因此2020年奇美醫學中心神經外科暨電腦刀中心主任王哲川引進脊椎微創一次性手術工具,提供病人另一個減少感染機率的選擇。在兩年多25位病人的經驗中,手術部位感染0,術後再手術率0,平均住院日5.7天,平均術前疼痛指數8可降至術後一週小於2,整體手術滿意度高達九成五。
脊椎微創手術目前已是神經外科專科醫師必備的手術技巧,但並非每個病人都適合用微創手術解決病痛,仍須跟你信任的醫師仔細討論。目前傳統的骨融合手術健保是可有條件給付需手術前跟健保局申請,但脊椎微創手術的骨釘健保目前尚未給付。
王哲川表示,脊椎手術過去因為一些不如預期結果的案例,讓民眾擔心害怕手術後需坐輪椅,隨著醫師訓練精實加上手術工具的精進,手術後造成癱瘓的機率已降至非常低,因此建議民眾如果有脊椎相關問題,可以找你信任的醫師討論找到一個最適合自己的治療方式(包括安全性、費用及預期的效果)
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