使用脊柱全内镜系统成功治疗腰椎黄韧带血肿
Successful treatment of lumbar ligamentum flavum hematoma using a spinal full-endoscopic system.
作者信息
Kaneko Takeshi, Oshima Yasushi, Inoue Hirokazu, Iwai Hiroki, Takano Yuichi, Inanami Hirohiko, Koga Hisashi
机构信息
PELD Center, Iwai Orthopaedic Medical Hospital, Tokyo, Japan.
Department of Orthopaedic Surgery, Inanami Spine and Joint Hospital, Tokyo, Japan.
出版信息
J Spine Surg. 2018 Dec;4(4):744-749. doi: 10.21037/jss.2018.09.09.
BACKGROUND
Percutaneous endoscopic lumbar discectomy (PELD) is a relatively less invasive treatment for lumbar disc herniation (LDH). This study investigated the usefulness of a full-endoscopic system for PELD in lumbar ligamentum flavum hematoma (LFH) treatment.
METHODS
Between May 2017 and Jun 2018, a total of five patients with leg pain due to LFH underwent surgery using a full-endoscopic system for PELD. A percutaneous endoscopic translaminar approach (PETA) was performed right above the LFH. Pathological examination of the hematoma capsule was performed in all cases.
RESULTS
The mean age of the patients was 64 years; there were 3 male and 2 female patients. Leg pain improved immediately after operation in all cases. Intraoperative findings and pathological examination revealed that the synovium at adjacent facet joints was not involved.
CONCLUSIONS
Full-endoscopic system is not only a safe and effective minimally invasive system for the treatment of lumbar LFH, but is also superior to acquire a correct diagnosis.
背景
经皮内镜下腰椎间盘切除术（PELD）是治疗腰椎间盘突出症（LDH）的一种侵入性相对较小的方法。本研究探讨了全内镜系统在经皮内镜下腰椎黄韧带血肿（LFH）治疗中的应用价值。
方法
2017年5月至2018年6月，共有5例因LFH导致腿痛的患者接受了使用全内镜系统进行的PELD手术。在LFH正上方采用经皮内镜下经椎板入路（PETA）。所有病例均对血肿包膜进行了病理检查。
结果
患者的平均年龄为64岁；男性3例，女性2例。所有病例术后腿痛均立即改善。术中发现及病理检查显示相邻小关节的滑膜未受累。
结论
全内镜系统不仅是治疗腰椎LFH的一种安全有效的微创系统，而且在获得正确诊断方面也更具优势。
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