DEVELOPMENTS OF FINE FIBERSCOPES AND IMAGE-ENHANCEMENT SYSTEM FOR EPIDURAL AND SUBARACHNOID SPACES

本文介绍了一种具有精细柔性纤维内窥镜的内窥镜系统，并进行了硬膜外和蛛网膜下腔观察的临床应用。l.内窥镜系统：研制了0.5、0.9和1.4mm φ的柔性纤维内窥镜，每根8 μ m的玻璃纤维在一个导像管中含有1000-3000个单元。内窥镜图像由电视摄像机拍摄，并在内窥镜检查期间进行监测。这些图像也被录像带记录下来。2.硬膜外和蛛网膜下腔内窥镜检查：将纤维内窥镜通过放置在L_或L_水平的14 G Touby针插入蛛网膜下腔或硬膜外腔<1-2><3-4>。硬膜外腔视野模糊，但有时韧带和硬膜显示清晰。为获得清晰的硬膜外腔图像，需改进聚焦装置或在纤维镜前端留出空间。蛛网膜下腔的视野基本清晰。脊髓、背根及脊髓血管清晰可见。脊髓背角面难以观察，枕大池图像清晰。φ 1.4mm纤维内窥镜的图像较其他细纤维内窥镜清晰。根据我们目前的内窥镜检查经验，我们认为这种内窥镜系统可以应用于硬膜外和蛛网膜下腔的诊断。通过增加用于将药物注射到纤维内窥镜的通道，该系统还将用于治疗椎管内的一些疾病。

An endoscope system with fine flexible fiberscopes was developed and clinical applications of the system for observation of epidural and subarachnoid spaces were carried out. l.Endoscope system: The endoscope equipped with 0.5, 0.9 or 1.4mmphi flexible fiberscope which contains 1000-3000 elements of 8mu m glass fiber in an image guide were manufactured. Images of the endoscope were taken by an TV camera and monitored during endoscopy. The images were also recorded with videotape. 2.Endoscopy of epidural and subarachnoid spaces: The fiberscopes were inserted into subarachnoid or epidural spaces through a 14G Touby needle placed at the level of L_<1-2> or L_<3-4>. View in epidural space was obscure, but sometimes the clear images of ligament and dura were observed. The improvement of focusing device or making a space at the tip of the fiberscope may be required to obtain the clear images of epidural spaces. The view of the subarachnoid space was generally clear. Spinal cord, dosal roots and vessels on the spinal cord were distinctly observed. Ventral surface of spinal cord were difficult to observe, but images of cisterna magna could be clearly observed. The image taken by 1.4mm phi fiberscope was more distinct than those taken by the other finer fiberscopes. From the experience of our endoscopy so far, it is suggested that this endoscope system could be applicable to the diagnosis in epidural and subarachnoid spaces. With addition of channels for injection of drugs to the fiberscopes, the system will also be used to treat some disorders in the spinal canal.