Application Of Improved Methylene Blue Marking Method In The Location Of Lumbar Degenerative Disease Operation

1 BackgroundLumbar degenerative disease is a common disease, It is a serious threat to human health. Operation is an important treatment of severe lumbar degenerative disease. Accurate positioning is an important foundation for the design of Spinal surgery incision and the smooth implementation of the surgery. It is a key step to ensure the Spinal surgery achieved good result.There are four kinds of positioning methods of spinal surgery:surface anatomy mark positioning method, Preoperative marking positioning method, Preoperative injection of methylene blue marker method and intraoperative positioning method. Among them, the surface anatomy mark positioning method is influenced by many factors, and it is not very reliability, can not be used independently for spine surgery, only serve as the basis and preliminary reference for other localization methods; All kinds of preoperative marking positioning methods are difficult to achieve one hundred percent accuracy; Intraoperative positioning method is very reliable, but it still has many shortcomings,for example, extending the operation time, increasing the operation wound and the chance of contamination trauma during operation; Preoperative injection of methylene blue marker method can improve the accuracy of preoperative localization, but it may cause more pain and trauma, a lot of methylene blue in the marking place makes the dyeing area too wide, makes it difficult to judge, So it is not entirely reassuring. So there is a problem to be solved urgently to establish a kind of accurate, safe, minimally invasive and simple location method in posterior lumbar surgery..2 Objective2.1 Our objective is to propose a new positioning method to avoid the disadvantage of methylene blue marker method, then observe the application value in posterior lumbar surgery.2.2 In order to establish an accurate, safe, minimally invasive, simple positioning method in posterior lumbar surgery.3 Method3.1 we propose a new positioning method to avoid the disadvantage of methylene blue marker method:After anesthesia, we use small syringe needle inject the supraspinous ligament above the spinous process with a few methylene blue.3.2 The improved methylene blue positioning method was applied to 89 cases of posterior lumbar spine surgery, then observe its accuracy, complications.3.3 According to the literature, the improved positioning method is compared with currently commonly used locating methods including Preoperative positioning method and intraoperative positioning method, then analysis its advantages and existing defects4 Results4.1 We have established a new methylene blue positioning method:After anesthesia, we use small syringe needle inject the supraspinous ligament above the spinous process with a few methylene blue.4.2 The improved methylene blue positioning method was applied to 89 cases of posterior lumbar spine surgery, the results:(1) All the 89 cases were accurately located,the accuracy rate was 100%; (2) During the process of locating, we use the fluoroscopy 1-2 times, positioning time 2-4 minutes, marking position was clear and circumscribed. (3) There is not exist any complication related by this modified methylene blue positioning method.4.3 Compared with currently commonly used locating methods including Preoperative positioning method and intraoperative positioning method, this new methylene blue positioning method has fully reflected its advantages and without obvious defect.5 ConclusionThis modified methylene blue positioning method absorbs the advantages of the currently commonly used locating methods including Preoperative positioning method and intraoperative positioning method, and overcomes their defects. It has many advantages,such as accurate, safe, minimally invasive, rapid, easy to operate.