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椎间孔镜激光神经减压术治疗移位型腰椎间盘突出症:病例系列

Epiduroscopic laser neural decompression as a treatment for migrated lumbar disc herniation: Case series.

作者信息

Oh Jinyoung, Jo Daehyun

机构信息

Department of Anesthesiology and Pain Medicine, Daejeon St. Mary's hospital, The Catholic University of Korea, Daejeon, Korea.

出版信息

Medicine (Baltimore). 2018 Apr;97(14):e0291. doi: 10.1097/MD.0000000000010291.

Abstract

OBJECTIVE

Epiduroscopic laser neural decompression (ELND) is one of the more invasive techniques for managing patients with herniated lumbar disc. However, ELND can be used to treat, and diagnose the epidural pathology; indications for ELND remain controversial, especially, when applied in cases of large disc extrusion and migrated disc. This paper reports cases of patients that were satisfied with the ELND procedure for migrated lumbar disc herniation.

METHODS

We reviewed the medical records of patients that received ELND for migrated lumbar disc in an outpatient clinic. The patients complained of low back pain with radicular pain with an intensity over 5 on a numeric rating scale (NRS) that had persisted for over 1 month. The Magnetic resonance imaging (MRIs) showed migrated lumbar disc herniation, and patients opted for ELND because they had previously experienced nerve blocks, and did not want to receive open surgery for their pain, even after the limitations of ELND were explained.

RESULTS

Patients reported that their pain was dramatically reduced, and other discomfort symptoms, such as numbness, were also reduced after the procedure. In follow-up, all of the patients were satisfied with the results.

CONCLUSION

We applied the ENLD procedure to mechanically, remove disc material that compressed the spinal nerve, and the patients were satisfied, and reported symptom relief. ELND was a sufficient treatment approach for lumbar migrated herniated disc for patients who did not want to undergo open spine surgery.

摘要

目的

硬膜外腔镜激光神经减压术(ELND)是治疗腰椎间盘突出症患者的侵入性较强的技术之一。然而,ELND可用于治疗和诊断硬膜外病变;ELND的适应证仍存在争议,尤其是在应用于大型椎间盘突出和游离椎间盘的病例时。本文报告了对ELND治疗游离性腰椎间盘突出症手术满意的患者病例。

方法

我们回顾了在门诊接受ELND治疗游离性腰椎间盘突出症患者的病历。患者主诉下腰痛伴神经根性疼痛,数字评分量表(NRS)评分强度超过5分,且持续超过1个月。磁共振成像(MRI)显示游离性腰椎间盘突出症,患者选择ELND是因为他们之前接受过神经阻滞治疗,并且即使在解释了ELND的局限性后,仍不想因疼痛接受开放手术。

结果

患者报告术后疼痛显著减轻,其他不适症状,如麻木感也有所减轻。随访中,所有患者对结果均满意。

结论

我们应用ENLD手术机械性地去除压迫脊神经的椎间盘物质,患者满意并报告症状缓解。对于不想接受开放性脊柱手术的患者,ELND是治疗腰椎游离性椎间盘突出症的一种充分的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52f0/5902256/5e6f319e6020/medi-97-e0291-g002.jpg

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