Department of Orthopaedic Surgery, The Royal Infirmary of Edinburgh, Little France Crescent, Edinburgh EH16 4SU, United Kingdom.
Surgeon. 2012 Oct;10(5):290-6. doi: 10.1016/j.surge.2012.05.001. Epub 2012 Jun 15.
Lumbar disc prolapse is common and the primary method of care in most centres is still open discectomy facilitated by microscope or loupe magnification and illumination. Hospitalisation may be less than 24 h, but post-operative pain usually requires an overnight stay. This review describes transforaminal endoscopic spinal surgery (TESS) using HD-video technology, that is generally performed as a day case procedure under sedation or light general anaesthesia, and collates the evidence comparing the technique to microdiscectomy.
The method of TESS is described and an electronic literature search performed to identify papers reporting clinical outcomes. International data were translated where necessary and proceedings' abstracts included. In addition, papers held by the authors and colleagues in personal libraries were carefully cross-referenced to the obtained database.
Analysis of the data supports the use of a transforaminal endoscopic approach to the lumbar intervertebral disc and suggests that outcomes following surgery are at least equivalent to those following microdiscectomy. Significant cost-savings in terms of in-patient stay may be generated. In addition, there is also some evidence supporting endoscopic surgery for relief of foraminal stenosis.
Based on current evidence there are good arguments supporting a more wide-spread adoption of transforaminal endoscopic surgery for the treatment of lumbar disc prolapse with or without foraminal stenosis.
腰椎间盘突出症较为常见，大多数中心的主要治疗方法仍然是在显微镜或放大镜和照明的辅助下进行开放式椎间盘切除术。住院时间可能不到 24 小时，但术后疼痛通常需要过夜。本文描述了使用高清视频技术的经椎间孔内窥镜脊柱手术（TESS），该手术通常在镇静或轻度全身麻醉下作为日间手术进行，并对该技术与显微椎间盘切除术的比较进行了证据汇总。
描述了 TESS 的方法，并进行了电子文献检索以确定报告临床结果的论文。必要时翻译了国际数据，并包括会议摘要。此外，作者和同事个人图书馆中持有的论文也与获得的数据库进行了仔细的交叉引用。
数据分析支持使用经椎间孔内窥镜方法治疗腰椎间盘，并表明手术后的结果至少与显微椎间盘切除术相当。在住院方面可能会节省大量成本。此外，还有一些证据支持内窥镜手术治疗椎间孔狭窄。
基于目前的证据，有充分的理由支持更广泛地采用经椎间孔内窥镜手术治疗伴或不伴椎间孔狭窄的腰椎间盘突出症。
