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腰椎侧弯合并腰椎管狭窄症及椎间盘突出症确诊患者接受了“U”形路径经皮椎间孔镜下腰椎间盘切除术治疗。

Lumbar Scoliosis Combined Lumbar Spinal Stenosis and Herniation Diagnosed Patient Was Treated with "U" Route Transforaminal Percutaneous Endoscopic Lumbar Discectomy.

作者信息

Wu Binbin, Zhang Shaobo, Lian Qingquan, Yan Haibo, Lin Xianfa, Zhan Gonghao

机构信息

Department of Anesthesiology and Pain Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China.

Department of Anesthesiology and Pain Medicine, The Hospital of Integrated Traditional and Western Medicine, Taizhou 317500, China.

出版信息

Case Rep Orthop. 2017;2017:7439016. doi: 10.1155/2017/7439016. Epub 2017 Jan 19.

Abstract

The objective was to report a case of a 63-year-old man with a history of low back pain (LBP) and left leg pain for 2 years, and the symptom became more serious in the past 5 months. The patient was diagnosed with lumbar scoliosis combined with lumbar spinal stenosis (LSS) and lumbar disc herniation (LDH) at the level of L4-5 that was confirmed using Computerized Topography and Magnetic Resonance Imaging. The surgical team preformed a novel technique, "U" route transforaminal percutaneous endoscopic lumbar discectomy (PELD), which led to substantial, long-term success in reduction of pain intensity and disability. After removing the osteophyte mass posterior to the thecal sac at L4-5, the working channel direction was changed to the gap between posterior longitudinal ligament and thecal sac, and we also removed the herniation and osteophyte at L3-4 with "U" route PELD. The patient's symptoms were improved immediately after the surgical intervention; low back pain intensity decreased from preoperative 9 to postoperative 2 on a visual analog scale (VAS) recorded at 1 month postoperatively. The success of the intervention suggests that "U" route PELD may be a feasible alternative to treat lumbar scoliosis with LSS and LDH patients.

摘要

目的是报告一例63岁男性患者,有2年的腰痛(LBP)和左腿疼痛病史,且在过去5个月症状加重。该患者被诊断为腰椎侧弯合并腰椎管狭窄(LSS)以及L4 - 5水平的腰椎间盘突出症(LDH),通过计算机断层扫描和磁共振成像得以确诊。手术团队采用了一种新技术,即“U”形路径经椎间孔腰椎后路内窥镜椎间盘切除术(PELD),在减轻疼痛强度和残疾程度方面取得了显著的长期成功。在L4 - 5处切除硬膜囊后方的骨赘后,将工作通道方向改为后纵韧带与硬膜囊之间的间隙,并且我们还用“U”形路径PELD切除了L3 - 4处的突出物和骨赘。手术干预后患者症状立即改善;术后1个月记录的视觉模拟量表(VAS)显示,腰痛强度从术前的9分降至术后的2分。该干预的成功表明,“U”形路径PELD可能是治疗患有LSS和LDH的腰椎侧弯患者的一种可行替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d19/5288505/a0f8c42f2f85/CRIOR2017-7439016.001.jpg

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