Kim Hyeun Sung, Adsul Nitin, Ju Yoon Seok, Kim Ki Joon, Choi Sung Ho, Kim Jeong Hoon, Chung Sung Kyun, Choi Jeong-Hoon, Jang Jee-Soo, Jang Il-Tae, Oh Seong-Hoon
Department of Neurosurgery, Nanoori Gangnam Hospital, Seoul, Republic of Korea.
Department of Neurosurgery, Nanoori Gangnam Hospital, Seoul, Republic of Korea.
World Neurosurg. 2018 Nov;119:500-505. doi: 10.1016/j.wneu.2018.06.133. Epub 2018 Jun 26.
Partially calcified lumbar herniated nucleus pulposus (HNP) can cause severe radiating pain and neurologic symptoms requiring surgical treatment. As it is not safe to enforce conventional endoscopic lumbar discectomy using trephine or burr to remove the partially calcified disc, we report a calcification floating technique using a working channel for the treatment of these cases.
We retrospectively analyzed 31 patients who underwent full endoscopic discectomy using this technique for partially calcified lumbar HNP between April 2009 and June 2013. Calcification floating technique was performed by inserting the working channel around the partially calcified HNP and then rotating the working channel around it to remove the lesion. We analyzed the outcomes with a Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), and complication rate.
The mean follow-up period was 26.58 ± 11.2 months. The interlaminar approach was used in 15 cases, and the transforaminal approach was used in 16 cases. The mean VAS of 8.19 ± 0.65 before surgery was decreased to 1.29 ± 0.69 at the last follow-up. The mean ODI score before surgery was decreased at the last follow-up, from 41.32 ± 2.87 to 9.87 ± 3.47. Mean operative duration was 45 ± 12 minutes per level. None of the patients required revision surgery or developed any major complication.
Calcification floating technique is a safe and effective method for the treatment of partially calcified lumbar HNP.
部分钙化的腰椎间盘突出症（HNP）可导致严重的放射性疼痛和神经症状，需要手术治疗。由于使用环锯或钻头进行传统的内镜下腰椎间盘切除术来切除部分钙化的椎间盘不安全，我们报告一种使用工作通道的钙化漂浮技术来治疗这些病例。
我们回顾性分析了2009年4月至2013年6月间31例行全内镜下椎间盘切除术治疗部分钙化腰椎HNP的患者。钙化漂浮技术是通过将工作通道插入部分钙化的HNP周围，然后围绕其旋转工作通道以切除病变。我们用视觉模拟量表（VAS）、Oswestry功能障碍指数（ODI）和并发症发生率分析结果。
平均随访期为26.58±11.2个月。15例采用椎间孔入路，16例采用经椎间孔入路。术前平均VAS为8.19±0.65，末次随访时降至1.29±0.69。术前平均ODI评分在末次随访时从41.32±2.87降至9.87±3.47。平均手术时间为每节段45±12分钟。所有患者均无需翻修手术，也未发生任何严重并发症。
钙化漂浮技术是治疗部分钙化腰椎HNP的一种安全有效的方法。
