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内镜辅助下胸腰椎侧方椎体切除术

Endoscope-assisted thoracolumbar lateral corpectomy.

作者信息

Carozzo Claude, Maitre Pierre, Genevois Jean-Pierre, Gabanou Pierre-Alexandre, Fau Didier, Viguier Eric

机构信息

Université de Lyon, VetAgroSup-Campus Vétérinaire de Lyon, Marcy L'Etoile, France.

出版信息

Vet Surg. 2011 Aug;40(6):738-42. doi: 10.1111/j.1532-950X.2011.00862.x. Epub 2011 Jul 19.

Abstract

OBJECTIVE

To report an endoscope-assisted lateral approach to expose the intervertebral foramen and disk and perform lateral corpectomy of thoracolumbar disks in dogs.

STUDY DESIGN

Cadaver study.

ANIMALS

Fresh canine cadavers (n=6).

METHODS

A thoracic (T10-T11) and a lumbar (L3-L4) lateral approach were made on 6 fresh canine mixed breed cadavers. Through a limited skin incision, musculature was dissected and retracted using a neurosurgical self-retaining retractor and lateral corpectomy performed. The approach and bone removal, both performed under endoscopic control, were assessed.

RESULTS

The foramen and intervertebral disk were clearly observed in all specimens without any iatrogenic injury of the ventral and dorsal nerve branches. Access to the foramen was possible in all specimens; in the thoracic area the head of the rib was always partially excised to observe the intervertebral disk medially. Lateral corpectomy was easily performed in all cadavers and spinal cord observation was good. Extension to foraminotomy or mini hemilaminectomy could easily be performed through the same limited approach.

CONCLUSION

Endoscopic exploration provided a good viewing of the intervertebral disk and/or foramen. An endoscope-assisted thoracolumbar lateral corpectomy could effectively be performed through a limited approach to the thoracolumbar disks and allowed good ventral spinal cord assessment.

摘要

目的

报告一种在内窥镜辅助下的外侧入路,用于暴露犬的椎间孔和椎间盘,并进行胸腰椎间盘的外侧椎体切除术。

研究设计

尸体研究。

动物

新鲜犬类尸体(n = 6)。

方法

对6具新鲜的犬类混合品种尸体进行胸椎(T10 - T11)和腰椎(L3 - L4)外侧入路。通过有限的皮肤切口,使用神经外科自动拉钩分离并牵开肌肉组织,然后进行外侧椎体切除术。评估在内窥镜控制下进行的入路和骨质切除情况。

结果

在所有标本中均能清晰观察到椎间孔和椎间盘,腹侧和背侧神经分支均未出现任何医源性损伤。所有标本均能进入椎间孔;在胸段区域,总是部分切除肋骨头部以便在内侧观察椎间盘。在所有尸体中均能轻松进行外侧椎体切除术,并且对脊髓的观察良好。通过相同的有限入路可以轻松扩展至椎间孔切开术或微型半椎板切除术。

结论

内镜探查能很好地观察椎间盘和/或椎间孔。通过有限的胸腰椎间盘入路可以有效地进行内镜辅助下的胸腰椎外侧椎体切除术,并能很好地评估脊髓腹侧情况。

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