改良经椎间孔内镜技术治疗椎管内合并椎间孔和/或椎间孔外腰椎间盘突出症
The modified transforaminal endoscopic technique in treating intracanalicular combining foraminal and/or extraforaminal lumbar disc herniations.
作者信息
Zhang Yong, Pan Zhimin, Yu Yanghong, Zhang Daying, Ha Yoon, Yi Seong, Shin Dong Ah, Sun Jingyi, Koga Hisashi, Phan Kevin, Azimi Parisa, Huang Wei, Cao Kai
机构信息
Pain Department, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China.
Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine, Seoul 03722, Republic of Korea.
出版信息
Quant Imaging Med Surg. 2018 Oct;8(9):936-945. doi: 10.21037/qims.2018.10.02.
BACKGROUND
To develop a modified transforaminal endoscopic spine system (TESSYS) technique for treating intracanalicular combining foraminal and/or extraforaminal lumbar disc herniation (ICFE-LDH), and evaluate the technical efficacy and safety.
METHODS
Twenty-three patients with ICFE-LDH underwent the modified TESSYS technique were enrolled. Magnetic resonance imaging (MRI) was used to verify the reduction of herniated disc. Pre- and post-operative neurological functions were compared by visual analogue scale (VAS) score, Oswestry disability index (ODI) and the modified MacNab criteria. The technical safety was evaluated by surgical complications.
RESULTS
MRI demonstrated reductions of disc herniations in 22 patients (95.7%) after surgeries. The VAS scores were significantly improved at 1 year follow-up (low back: P=0.001, lower limbs: P<0.001), as well as ODI scores (P<0.001). 22 patients had achieved excellent and good recovery postoperatively according to the modified MacNab criteria. One patient (4.3%) underwent a reoperation due to postoperative recurrence of disc herniation. Another patient complained postoperative causalgia in 8 weeks, the symptom alleviated after conservative treatment at 1 year follow-up (VAS: back, 3, lower limbs, 0; ODI: 20%). The incidence rate of surgical complication was 8.7%.
CONCLUSIONS
The modified TESSYS technique is a minimally-invasive, effective and safe surgery for treating ICFE-LDHs in selected patients.
背景
开发一种改良的经椎间孔内镜脊柱系统（TESSYS）技术用于治疗椎管内合并椎间孔和/或椎间孔外腰椎间盘突出症（ICFE-LDH），并评估该技术的疗效和安全性。
方法
纳入23例行改良TESSYS技术治疗的ICFE-LDH患者。采用磁共振成像（MRI）验证椎间盘突出的复位情况。通过视觉模拟量表（VAS）评分、Oswestry功能障碍指数（ODI）和改良MacNab标准比较术前和术后的神经功能。通过手术并发症评估技术安全性。
结果
MRI显示22例患者（95.7%）术后椎间盘突出有所减轻。随访1年时VAS评分显著改善（下腰部：P=0.001，下肢：P<0.001），ODI评分也显著改善（P<0.001）。根据改良MacNab标准，22例患者术后恢复良好。1例患者（4.3%）因椎间盘突出术后复发接受了再次手术。另1例患者术后8周出现灼性神经痛，随访1年经保守治疗后症状缓解（VAS：背部，3分；下肢，0分；ODI：20%）。手术并发症发生率为8.7%。
结论
改良TESSYS技术是一种针对特定患者治疗ICFE-LDH的微创、有效且安全的手术方法。
Zotero 插件