Hong Young-Ho, Kim Seung-Kook, Suh Dong-Won, Lee Su-Chan
Department of Spine Center, Barun-Sesang Hospital, 5, Yatap-ro 75 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13497, Korea.
Himchan UHS Spine and Joint Institute, University Hospital of Sharjah, University Street 1, Sharjah 72772, UAE.
Brain Sci. 2020 Aug 4;10(8):516. doi: 10.3390/brainsci10080516.
Post-laminectomy syndrome is a common cause of dissatisfaction after endoscopic interlaminar approach. Our aim was to evaluate the efficacy and safety of our two newly designed instruments for laminotomy, a dural protector attached to the scope and a knot pusher for water-tight suturing of the incidental dural tears.
This was a multicenter evaluation. Efficacy was quantified as the pre-to-postoperative improvement in pain (visual analog scale), disability (Oswestry Disability Index), patient satisfaction (modified MacNab score), and length of hospital stay. Safety was quantified by the incidence and location of dural tears, rate of revision, and radiological outcomes. Outcomes were evaluated between the control (before instrument development) and experimental (after instrument development) groups.
There was a significant improvement in leg pain in the experimental group ( = 0.03), with greater patient satisfaction in the control group ( < 0.01). There was no incidence of dural tears in the area of the traversing and exiting nerve roots in the experimental group. Water-tightness of sutures was confirmed radiologically.
The novel dural protector and the knot pusher for water-tight sutures improved the efficacy and safety of decompression and discectomy; however, a prolonged operative time was a drawback.
椎板切除术后综合征是内镜下椎间入路术后患者不满意的常见原因。我们的目的是评估我们新设计的两种椎板切开器械的有效性和安全性，一种是连接在镜上的硬脊膜保护器，另一种是用于对意外硬脊膜撕裂进行水密缝合的打结器。
这是一项多中心评估。有效性通过术前至术后疼痛（视觉模拟评分）、功能障碍（奥斯维斯特功能障碍指数）、患者满意度（改良MacNab评分）和住院时间的改善来量化。安全性通过硬脊膜撕裂的发生率和位置、翻修率以及影像学结果来量化。在对照组（器械开发前）和实验组（器械开发后）之间评估结果。
实验组腿痛有显著改善（ = 0.03），对照组患者满意度更高（ < 0.01）。实验组在横过和穿出神经根区域未发生硬脊膜撕裂。通过影像学证实了缝合的水密性。
新型硬脊膜保护器和用于水密缝合的打结器提高了减压和椎间盘切除术的有效性和安全性；然而，手术时间延长是一个缺点。
