Lee Han Gyu, Kang Moo Sung, Kim So Yeon, Cho Kwang Chun, Na Young Cheol, Cho Jin Mo, Jin Byung Ho
395886Catholic Kwandong University, International St. Mary's Hospital, Incheon, Republic of Korea.
H plus Yangji Hospital, Seoul, Republic of Korea.
Global Spine J. 2021 Jul;11(6):845-851. doi: 10.1177/2192568220941446. Epub 2020 Aug 7.
STUDY DESIGN: Retrospective study. OBJECTIVES: Unilateral biportal endoscopic surgery (UBES) is a popular surgical method used to treat degenerative spinal diseases because of its merits, such as reduced tissue damage and outstanding visual capacity. However, dural injury is the most common complication of UBES with an incidence rate of 1.9% to 5.8%. The purpose of this study was to analyze the pattern of dural injury during UBES and to report the clinical course. METHODS: We retrospectively reviewed the medical and radiographic records of surgically treated patients who underwent UBES at a single institute between January 2018 and December 2019. RESULTS: Fifty-three patients, representing 67 segments, underwent UBES. Seven dural injuries occurred, and the incidence rate was 13.2%. Among 16 far lateral approaches, 2 dural injuries of the exiting roots occurred and were treated with fibrin sealant reinforcement. Among 51 median approaches, dural injury occurred at the thecal sac (n = 3) and traversing root (n = 2). A dural injury of the shoulder of the traversing root was treated with a fibrin sealant; however, a defect in the thecal sac required a revision for reconstruction. The other 2 thecal sac injuries were directly repaired via microscopic surgery. CONCLUSIONS: Dural injury during UBES can occur because of the various anatomical features of the meningo-vertebral ligaments. Direct repair of the central dural defect should be considered under microscopic vision. A linear tear in the lateral dura or root can be controlled with a simple patchy reinforcement under endoscopic vision.
研究设计:回顾性研究。 目的:单侧双通道内镜手术(UBES)因其组织损伤小、视野良好等优点,是治疗退行性脊柱疾病常用的手术方法。然而,硬脊膜损伤是UBES最常见的并发症,发生率为1.9%至5.8%。本研究旨在分析UBES术中硬脊膜损伤的模式并报告临床过程。 方法:我们回顾性分析了2018年1月至2019年12月在单一机构接受UBES手术治疗患者的医疗和影像学记录。 结果:53例患者共67节段接受了UBES手术。发生7例硬脊膜损伤,发生率为13.2%。在16例远外侧入路中,2例出现出口神经根硬脊膜损伤,采用纤维蛋白胶加固治疗。在51例正中入路中,硬脊膜损伤发生在硬脊膜囊(n = 3)和走行神经根(n = 2)。走行神经根肩部的硬脊膜损伤采用纤维蛋白胶治疗;然而,硬脊膜囊缺损需要翻修重建。另外2例硬脊膜囊损伤通过显微手术直接修复。 结论:由于脊膜-椎体韧带的各种解剖特征,UBES术中可能发生硬脊膜损伤。中央硬脊膜缺损应在显微镜下直视下考虑直接修复。外侧硬脊膜或神经根的线性撕裂可在内镜直视下通过简单的补片加固来控制。
Global Spine J. 2021-7
World Neurosurg. 2018-11
Spine J. 2013-5-10
J Craniovertebr Junction Spine. 2015
World J Orthop. 2025-8-18
J Neurosurg Case Lessons. 2025-8-18
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2025-4-15
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2024-12-15
BMC Musculoskelet Disord. 2024-12-7
J Orthop. 2019-10-25
Neurospine. 2019-3
Asian Spine J. 2019-4
Neurospine. 2019-3