Khoueir Paul, Wang Michael Y
Department of Neurological Surgery, Université de Montréal, Montréal, Canada.
Department of Neurological Surgery, Miller School of Medicine, University of Miami, Miami, Florida.
SAS J. 2007 Nov 1;1(4):143-6. doi: 10.1016/SASJ-2007-0103-CR-R2. eCollection 2007.
Following an L5-S1 SB Charité disc III implantation, a 37-year-old female patient developed intractable radicular pain in the left L5 distribution. The patient underwent a minimally invasive foraminotomy, and her symptoms improved significantly. However, following recurrence of radicular pain, she showed signs of an L5-S1 facet degeneration and recurrent nerve root compression from hypertrophied synovium. A partial facetectomy was then performed to completely decompress the L5 root with supplemental posterior dynamic stabilization using a pedicle-based flexible titanium rod system. To date, the patient remains free of symptoms. Although posterolateral fusion would have been a viable option, the application of a posterior dynamic system permitted segmental motion preservation.
在进行L5-S1 SB Charité椎间盘III植入术后,一名37岁女性患者出现了左侧L5分布区域的顽固性神经根性疼痛。该患者接受了微创椎间孔切开术,症状明显改善。然而,神经根性疼痛复发后,她出现了L5-S1小关节退变的迹象以及肥厚滑膜导致的复发性神经根受压。随后进行了部分小关节切除术,使用基于椎弓根的柔性钛棒系统进行补充后路动态稳定,以完全减压L5神经根。迄今为止,该患者仍无症状。虽然后外侧融合本是一个可行的选择,但应用后路动态系统可保留节段运动。