Wu Pang Hung, Kim Hyeun-Sung, Jang Il-Tae
Nanoori Gangnam Hospital, Spine Surgery, Seoul, Korea.
National University Health System, JurongHealth Campus, Orthopaedic Surgery, Singapore.
Neurospine. 2020 Jul;17(Suppl 1):S20-S33. doi: 10.14245/ns.2040116.058. Epub 2020 Jul 31.
In the first phase of development of lumbar endoscopic spine surgery, the focus was on removal of soft disc material through the working corridor of Kambin's triangle using transforaminal endoscopic lumbar discectomy. With the introduction of the interlaminar approach and increased interest from both industry and surgeons, there has been an exponential development of endoscopic surgical equipment and a corresponding expansion of endoscopic techniques. Endoscopic treatment strategies are applied to conditions ranging from contained prolapsed intervertebral discs to noncontained migrated herniated discs, hard calcified discs, spinal stenosis in the central or lateral recess and the foraminal and extraforaminal region, and other combinations of degenerative conditions requiring decompression or fusion surgery. The further expansion of endoscopic surgical management involving complicated spinal cases and the final quartet of trauma, infections, tumors, and possibly deformities could be the future stage of endoscopic spine surgery development. This article covers the full range of current treatment strategies and presents possible future developments of endoscopic spine surgery for the management of lumbar spinal conditions.
在腰椎内镜脊柱手术发展的第一阶段，重点是通过经椎间孔内镜腰椎间盘切除术，经Kambin三角的工作通道去除软性椎间盘物质。随着椎板间入路的引入以及行业和外科医生兴趣的增加，内镜手术设备呈指数级发展，内镜技术也相应扩展。内镜治疗策略适用于多种病症，从包容性脱垂椎间盘到非包容性移位突出椎间盘、硬钙化椎间盘、中央或侧隐窝以及椎间孔和椎间孔外区域的椎管狭窄，以及其他需要减压或融合手术的退行性病症组合。涉及复杂脊柱病例以及创伤、感染、肿瘤和可能的畸形这最后四类病症的内镜手术管理的进一步扩展，可能是内镜脊柱手术发展的未来阶段。本文涵盖了当前所有的治疗策略，并介绍了内镜脊柱手术在治疗腰椎疾病方面可能的未来发展。
