Episode Transcript
Interviewer: 所以你或你所爱的人选择了内窥镜脊柱手术而不是更传统的方法. 在手术当天和之后你能期待什么?
We're here with Dr. Mark Mahan. He's an associate professor of neurosurgery at the University of Utah Health. Now, Dr. Mahan, when it comes to endoscopic spinal surgery, what can someone expect, you know, leading up to the procedure, the day after? Where do they start? And what should they be expecting?
Dr. Mahan: The wonderful thing about endoscopic spine surgery 99%的病例都是门诊手术吗. 这是对个人期望的重构, because it's not a traditional come to the hospital, stay there for several days, eat wonderful hospital food, stay in wonderful hospital beds. 这是你在大发娱乐的门诊地点可以预料到的. A patient would expect to arrive that day. Typical requirements are for, you know, for any surgery are, you know, no eating from the night before, coming in, unfortunately, you know, 有点早，因为大发娱乐都喜欢早点结束一天的生活, and so we try to get started early.
然后你会期望你会遇到一大堆新的人，他们会来照顾你. 这意味着大发娱乐会有护士和其他人来检查，确保你准备好了. We'll go through a surgical consent. 这对我个人来说很重要，因为我想确保每个人都理解, ahead of time, both what the surgery entails, what the risks are, 你对恢复期和长期的期望是什么. 这样大发娱乐就能就大发娱乐的目标和你们将面临的问题达成共识. 然后，你知道，如何最好地优化你的长期恢复.
And then after surgery, obviously, these are generally performed under general anesthesia, 哪种麻醉需要使用呼吸管. And so waking up, 来的时候通常是大多数人不记得的时候, fortunately, and then just recovery, make sure that you've, you know, that you're ready to go, you're steady on your feet, that you're eating, you're feeling well, and then we get you back to your car and you can go home.
Interviewer: 那么像这样的手术你要在手术室里待多久呢?
Dr. Mahan: 一般来说，这取决于大发娱乐想要治疗的问题是什么. 有些椎间盘手术进行得非常非常快，大约半个小时.
Interviewer: Oh, wow.
Dr. Mahan: Now some of the more complex narrowing can be two hours. 这真的取决于需要做什么工作.
Interviewer: Now, after the patient is home, what can they expect? We're dealing with pain control, recovery. How long until they're back on their feet, etc.?
Dr. Mahan: Yeah, now, 疼痛控制是我特别关注的一个问题因为我真的希望每个人都能有一条平稳的道路，因为, you know, 尽管内窥镜技术是为了尽量减少组织损伤, it is still a spine surgery. It is still the goal of removing something from your spine. I don't want to make that sound scary, but I don't want to make other people feel like, oh, it's a magical procedure, right? It's not. 这是一个现实，大发娱乐正在移除一些压迫神经并引起疼痛和不适的东西.
所以你可能会有一些刺激或不适从你的脊椎中取出一些东西. 所以我要做的就是尽我所能使它最小化. 第一，内窥镜技术，最小的切口，最小的方法. Number two, 经常使用大量的麻醉药物真的可以使恢复更直接. 所以大发娱乐会在脊柱肌肉中使用长效麻醉剂让它们舒适放松甚至在大发娱乐开始做手术之前.
So the first step, block the muscles. Make it comfortable. 它还会导致皮肤切口处的皮肤麻木，这样就不会太不舒服了. But the block will wear off. So the things that we do is try to, obviously, 避免大量强效止痛药，因为强效止痛药可能有副作用和后果. So we're using things like ice, heat, anti-inflammatories, 然后大发娱乐谈到了较轻的止痛药这样你就不会遇到与强效止痛药相关的并发症.
Interviewer: Now other than the pain management that happens afterwards, when they go home, are they up for a day or two? Are they on their back for a day or two? On their belly? 比如，你让病人做什么才能从这样的手术中恢复过来?
Dr. Mahan: 在大多数情况下，你正在做你想做的事情.
Interviewer: Oh wow.
Dr. Mahan: Yeah, 如果有人有椎间盘突出，限制就会出现, we want to minimize the risk of re-herniation, 也就是说椎间盘的另一部分断裂压迫神经根, which can occur. 除了椎间盘突出，我希望每个人都尽可能多地做他们觉得舒服的运动. Oftentimes that sometimes means tempering people. 我有一个病人手术后的第二天他问我能不能骑雪地车上山. And I was like, it was one of those moments where you have that sort of, you know, common sense questions, like, well, 告诉我，如果你爬到一半的时候背部痉挛会发生什么? You had difficulty coming back?
Interviewer: Right?
Dr. Mahan: 然后，你知道，他说，好吧，也许这不是今天最好的事情. 你会说，手术后的第二天可能不太适合发疯. But people will be walking more. People will be doing more activities. And we want that. 大发娱乐希望他们回到自己选择的生活方式.
Interviewer: 现在，令人印象深刻的是，他们在手术后的第二天或一两天内就能恢复正常. 也许比他们平时做的要温和一些. But, you know, not going back up and doing crazy mountain biking, or that snowmobile trip, like you mentioned. But how long until a patient is, you know, 一直都痊愈了，从手术中获益最多, and they're back to normal?
Dr. Mahan: That is an excellent question. And it really is patient-specific. 所以如果有人有更严重的神经压迫或神经损伤, and it's been there for a long period of time, meaning that it's going to take longer for their recovery, right? So if you've had a problem that is minor in nature, and it's a short duration, your recovery is going to be quick. 如果你有一个非常深刻的问题，持续很长时间, you know, there may be a new normal, even with spine surgery. 大发娱乐不能总是抹去时间里发生的一切，但大发娱乐会尝试的.