Kim Kwang-Ryeol, Park Jeong-Yoon
Department of Neurosurgery, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea.
Department of Neurosurgery, Spine and Spinal Cord Institute, Gangnam Severance Spine Hospital, Yonsei University College of Medicine, Seoul, Korea.
Neurospine. 2020 Jul;17(Suppl 1):S154-S159. doi: 10.14245/ns.2040174.087. Epub 2020 Jul 31.
Minimally invasive techniques for transforaminal lumbar interbody fusion (MIS-TLIF) are advantageous because they allow for sufficient surgical exposure and fewer complications through a smaller incision than conventional TLIF. It could be difficult to maintain minimally invasive spine surgery following the unexpected complications after MIS-TLIF. Because MIS-TLIF is usually done via a paramedian small incision with posterior fusion using screws and rods, visualization of the surgical field is limited, and it is difficult to directly assess the neural structure without removing instrumentation. Unilateral biportal endoscopic decompression (UBE) is a rapidly growing surgical method using two 1-cm incisions that are 2 to 3 cm apart. We would like to suggest UBE as an option for immediate reoperation after MIS-TLIF because it has the advantages of targeting pathologic regions and a wide field of visualization through small wounds. The operation is independent of the existing incision from MIS-TLIF, enabling immediate revision surgery without the removal of the screws and rods. UBE has the advantages of targeting specific surgical regions and providing a wide visualization of the operation field through small incisions. UBE can be very useful for discectomy or decompression surgery as well as in immediate reoperation after MIS-TLIF.
经椎间孔腰椎椎间融合术的微创技术(MIS-TLIF)具有优势,因为与传统TLIF相比,它通过更小的切口就能实现足够的手术暴露且并发症更少。MIS-TLIF术后出现意外并发症后,可能难以维持微创脊柱手术。由于MIS-TLIF通常通过旁正中小切口进行,使用螺钉和棒进行后路融合,手术视野的可视化受到限制,并且在不拆除器械的情况下很难直接评估神经结构。单侧双通道内镜减压术(UBE)是一种迅速发展的手术方法,使用两个相距2至3厘米的1厘米切口。我们建议将UBE作为MIS-TLIF术后立即再次手术的一种选择,因为它具有通过小切口靶向病变区域和视野广阔的优点。该手术独立于MIS-TLIF现有的切口,无需拆除螺钉和棒即可立即进行翻修手术。UBE具有靶向特定手术区域并通过小切口提供广阔手术视野的优点。UBE对于椎间盘切除术或减压手术以及MIS-TLIF术后立即再次手术非常有用。