Sasani Mehdi, Ozer Ali Fahir, Oktenoglu Tunc, Kaner Tuncay, Aydin Sabri, Canbulat Nazan, Carilli Senol, Sarioglu Ali Cetin
American Hospital, Neurosurgery Department, Istanbul, Turkey.
Turk Neurosurg. 2010 Jul;20(3):373-81. doi: 10.5137/1019-5149.JTN.2980-10.1.
Minimally invasive surgery is currently a goal for surgical intervention in the spine. The effectiveness of endoscopic thoracic spine surgery and technological improvements are two factors that are always under consideration in the practice of spinal surgery.
We present twenty-five patients whose thoracoscopic spinal surgeries were performed between 2002 and 2008 for the treatment of various spinal diseases. Eleven patients with thoracic disc herniation, five patients with traumatic thoracic spinal compressive fracture, six patients with metastatic thoracic spinal tumors and three patients with tubercular spondylitis underwent thoracoscopic spine surgery. Clinical evaluations were performed at 3, 6,12 and 24 months post-surgery. The Oswestry disability questionnaire and linear visual analog scale (VAS) were used for the evaluation of pain.
Postoperatively, two patients had lung contusions, one patient had pneumonia and one patient had instability. There were significant initial improvements in both the Oswestry score and the VAS pain score up to 6 months (p<0.05). The average relative difference in pain scores in all groups was not significant at 12 and 24 months (p>0.05).
The favorable results of thoracoscopic spinal surgery encourage its application to situations in which a conventional thoracic approach is indicated. Thoracoscopic spine surgery is applicable to all patients with various spinal diseases.
微创手术是目前脊柱外科干预的目标。内窥镜胸椎手术的有效性和技术改进是脊柱外科实践中始终需要考虑的两个因素。
我们介绍了2002年至2008年间接受胸腔镜脊柱手术以治疗各种脊柱疾病的25例患者。11例胸椎椎间盘突出症患者、5例创伤性胸椎压缩性骨折患者、6例转移性胸椎肿瘤患者和3例结核性脊柱炎患者接受了胸腔镜脊柱手术。术后3、6、12和24个月进行临床评估。采用Oswestry功能障碍问卷和线性视觉模拟量表(VAS)评估疼痛情况。
术后,2例患者出现肺挫伤,1例患者发生肺炎,1例患者出现脊柱不稳定。直至6个月时,Oswestry评分和VAS疼痛评分均有显著的初始改善(p<0.05)。在12个月和24个月时,所有组疼痛评分的平均相对差异不显著(p>0.05)。
胸腔镜脊柱手术的良好效果促使其应用于需要采用传统开胸手术的情况。胸腔镜脊柱手术适用于所有患有各种脊柱疾病的患者。