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全内镜下经椎弓根椎间盘切除术治疗腰椎间盘突出症：病例报告及文献综述

Full-endoscopic transpedicular discectomy (FETD) for lumbar herniations: Case report and review of the literature.

作者信息

Giordan Enrico, Del Verme Jacopo, Coluzzi Flaminia, Canova Giuseppe, Billeci Domenico

机构信息

Department of Neurosurgery, Aulss 2 Marca Trevigiana, Treviso, Veneto, Italy.

Department of Neurosurgery, Aulss 2 Marca Trevigiana, Treviso, Veneto, Italy.

出版信息

Int J Surg Case Rep. 2020;72:137-141. doi: 10.1016/j.ijscr.2020.05.085. Epub 2020 Jun 9.

DOI:10.1016/j.ijscr.2020.05.085
PMID:32535528
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7298322/
Abstract

INTRODUCTION

One of the most challenging occurrences in full-endoscopic surgery for lumbar disc protrusions are up-migrated or down-migrated herniations. Those occurrences are difficult to retrieve with transforaminal or interlaminar approaches.

PRESENTATION OF CASE

We describe our experience in dealing with a right paramedian down-migrated L3-L4 disc herniation. The patient underwent full endoscopic transpedicular endoscopic discectomy (FETD), by reaming the right L4 peduncle for intracanal access and fragment retrieval. We also reviewed the recent literature to summarize the advantages of transpedicular approaches, along with current indications and contraindications for this procedure.

DISCUSSION

We highlighted how FETD is safe and feasible for down-migrated and up-migrated disc herniation showing excellent results in our patient and in the small cohorts of patients already published in the literature.

CONCLUSION

FETD was effective in treating up-migrated and down-migrated disc herniation, as well as discal cysts, showing the feasibility and safety of the technique from any level from L1 to S1.

摘要

引言

腰椎间盘突出症全内镜手术中最具挑战性的情况之一是向上或向下移位的椎间盘突出。经椎间孔或椎板间入路很难取出这些移位的椎间盘。

病例介绍

我们描述了处理一例右侧L3-L4椎间盘向右旁正中下移突出的经验。患者接受了全内镜经椎弓根椎间盘切除术（FETD），通过磨除右侧L4椎弓根以进入椎管并取出碎块。我们还回顾了近期文献，总结了经椎弓根入路的优势以及该手术的当前适应症和禁忌症。

讨论

我们强调了FETD对于向上和向下移位的椎间盘突出是安全可行的，在我们的患者以及文献中已发表的小队列患者中均显示出优异的效果。

结论

FETD在治疗向上和向下移位的椎间盘突出以及椎间盘囊肿方面是有效的，显示了该技术在从L1到S1任何节段的可行性和安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7f7/7298322/5515fae612a2/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7f7/7298322/7a773656db71/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7f7/7298322/1da095b6fb13/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7f7/7298322/68fe1202982d/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7f7/7298322/5515fae612a2/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7f7/7298322/7a773656db71/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7f7/7298322/1da095b6fb13/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7f7/7298322/68fe1202982d/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7f7/7298322/5515fae612a2/gr4.jpg

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