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经椎间孔途径经皮内镜下椎间盘囊肿切除术

Percutaneous Endoscopic Discectomy via Transforaminal Route for Discal Cyst.

作者信息

Jha Subash C, Higashino Kosaku, Sakai Toshinori, Takata Yoichiro, Abe Mitsunobu, Nagamachi Akihiro, Fukuta Shoji, Sairyo Koichi

机构信息

Department of Orthopedics, Tokushima University, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.

出版信息

Case Rep Orthop. 2015;2015:273151. doi: 10.1155/2015/273151. Epub 2015 Aug 19.

Abstract

Background. Discal cyst has been identified as a rare cause of low back pain and radiating leg pain. The pathogenesis and management of this condition are still debated. The largest number of reported cases had undergone microsurgery while very few cases have been treated with percutaneous endoscopic discectomy (PED). Methods. An 18-year-old boy complained of low back pain radiating to right leg after a minor road traffic accident. Diagnosis of a discal cyst at L4-L5 level was made based on magnetic resonance imaging (MRI). Despite conservative management for 6 months, the low back pain and radiating leg pain persisted so surgical treatment by PED was performed under local anesthesia. As the patient was a very active baseball player, his physician recommended a minimally invasive procedure to avoid damage to the back muscles. Results. The patient's low back pain and leg pain disappeared immediately after surgery and he made a rapid recovery. He resumed mild exercise and sports practice 4 weeks after surgery. Complete regression of the cystic lesion was demonstrated on the 2-month postoperative MRI. Conclusion. A minimal invasive procedure like PED can be an effective surgical treatment for discal cyst, especially in active individuals who play sports.

摘要

背景。椎间盘囊肿已被确认为下腰痛和放射性腿痛的罕见病因。这种疾病的发病机制和治疗方法仍存在争议。报告的病例中大多数接受了显微手术,而很少有病例采用经皮内镜下椎间盘切除术(PED)治疗。方法。一名18岁男孩在一次轻微交通事故后出现下腰痛并向右下肢放射。根据磁共振成像(MRI)诊断为L4-L5水平的椎间盘囊肿。尽管进行了6个月的保守治疗,下腰痛和放射性腿痛仍持续存在,因此在局部麻醉下采用PED进行手术治疗。由于该患者是一名非常活跃的棒球运动员,他的医生建议采用微创手术以避免损伤背部肌肉。结果。患者术后下腰痛和腿痛立即消失,恢复迅速。术后4周他恢复了轻度运动和体育锻炼。术后2个月的MRI显示囊肿病变完全消退。结论。像PED这样的微创手术可以成为治疗椎间盘囊肿的有效手术方法,尤其是对于从事体育运动的活跃个体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f54e/4556867/8961f6092186/CRIOR2015-273151.001.jpg

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