经皮椎间孔内镜下椎间盘切除术治疗椎间盘真菌感染继发外侧隐窝狭窄症。
Percutaneous transforaminal endoscopic discectomy for the treatment of lateral recess stenosis secondary occurred the discal fungus infection.
机构信息
The Affiliated Hangzhou Hospital of Nanjing Medical University, Hangzhou, 310006, China.
The affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine Hangzhou, 261# huansha road, Shangcheng District, Hangzhou City, 310006, Zhejiang Province, China.
出版信息
BMC Musculoskelet Disord. 2020 Mar 18;21(1):175. doi: 10.1186/s12891-020-03211-7.
BACKGROUND
This is a case of lateral recess stenosis secondary occurred the discal fungus infection treated with percutaneous transforaminal endoscopic discectomy (PTED). There has been no relevant reports before.
CASE PRESENTATION
A 49-year-old patient who had taken itraconazole for 13 months for lateral recess stenosis secondary occurred the discal fungus infection complained of gradually worsening radiating pain and numbness in the back and inguinal and inner thigh region of right side. In order to relieve the radiating neuralgia and reduce the damage to spinal stability, the minimally invasive PTED was performed.The patient's prognosis was assessed using Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS). During the follow-up, the patient's ODI and VAS scores were decreased significantly. The radiating pain in the inguinal and inner thigh region of right side were significantly alleviated and the discomfort caused by lower back instability was improved by plaster vest.
DISCUSSION AND CONCLUSION
PTED not only avoids further damage to the stability of the lumbar spine, but also effectively relieves the symptoms of leg neuroradialgia caused by lateral recess stenosis secondary occurred the discal fungus infection.
背景
这是一例盘源性真菌感染继发侧隐窝狭窄经皮椎间孔内镜椎间盘切除术（PTED）治疗的病例。此前尚无相关报道。
病例介绍
一名 49 岁患者因继发于盘源性真菌感染的侧隐窝狭窄接受伊曲康唑治疗 13 个月后，出现右侧背部和腹股沟及大腿内侧进行性加重的放射痛和麻木。为缓解放射神经痛并减少对脊柱稳定性的损害，采用微创经皮椎间孔内镜椎间盘切除术（PTED）进行治疗。采用 Oswestry 功能障碍指数（ODI）和视觉模拟评分（VAS）评估患者的预后。随访期间，患者的 ODI 和 VAS 评分均显著降低，右侧腹股沟和大腿内侧的放射痛明显缓解，通过佩戴石膏背心改善了下腰椎失稳引起的不适。
讨论和结论
PTED 不仅避免了对腰椎稳定性的进一步损害，而且有效缓解了继发于盘源性真菌感染的侧隐窝狭窄引起的下肢神经放射性痛症状。
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