Liu Xinchun, Zhu Yue
Department of Orthopedics, The First Hospital of China Medical University, Shenyang, Liaoning Province, People's Republic of China.
Clin Spine Surg. 2021 Jun 1;34(5):183-188. doi: 10.1097/BSD.0000000000001071. Epub 2020 Sep 22.
Technical report.
The aim was to present a full endoscopic technique for bilateral decompression of cervical stenosis caused by calcification of ligamentum flavum through a unilateral approach.
The minimally invasive surgical technique aims to preserve muscle and posterior structures to prevent iatrogenic instability and axial pain. Endoscopic resection of calcification of ligamentum flavum in the cervical spine has shown effectiveness. However, the removal of bilateral calcification lesions through a unilateral approach has been reported as an inadequate and technical demanding method.
The illustrative case showed myelopathy caused by bilateral calcification of ligamentum flavum in the C5/C6 segment. A spinal multichannel endoscope with a rigid rod-lens was used to the operation under saline media. After a laminotomy was performed on the ipsilateral side, both the ipsilateral and the contralateral calcified lesions were resected through the same bone window.
The patient's hand function and walk ability were found significantly improved the next day after surgery. Complete removal of calcified lesions was confirmed by postoperative imaging studies.
Removal of bilateral calcification lesions in the cervical spine through a unilateral approach is possible with a spinal endoscope.
技术报告。
旨在介绍一种通过单侧入路对黄韧带钙化所致颈椎管狭窄进行双侧减压的全内镜技术。
微创外科技术旨在保留肌肉和后部结构，以防止医源性不稳定和轴向疼痛。颈椎黄韧带钙化的内镜下切除术已显示出有效性。然而，通过单侧入路切除双侧钙化病变被报道为一种不充分且技术要求高的方法。
该病例显示C5/C6节段双侧黄韧带钙化导致脊髓病。在生理盐水介质下使用带有刚性棒状透镜的脊柱多通道内镜进行手术。在同侧进行椎板切除术后，通过同一骨窗切除同侧和对侧的钙化病变。
术后第二天发现患者的手部功能和行走能力明显改善。术后影像学检查证实钙化病变已完全切除。
使用脊柱内镜通过单侧入路切除颈椎双侧钙化病变是可行的。
