Kamada Mitsuhiro, Manabe Hiroaki, Yamashita Kazuta, Sakai Toshinori, Maeda Toru, Sairyo Koichi
Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Tokushima, Japan.
NMC Case Rep J. 2020 Sep 21;7(4):173-177. doi: 10.2176/nmccrj.cr.2019-0075. eCollection 2020 Sep.
Back pain and lower extremity pain have various causes and occasionally occur simultaneously, creating diagnostic difficulties. In addition, athletes require special consideration in terms of treatment. Here, we report a case of foraminal stenosis as a result of lumbar disc prolapse combined with facet hypertrophy contralateral to the dominant hand in a baseball pitcher that was successfully treated by minimally invasive full-endoscopic surgery. A 31-year-old left-handed male baseball pitcher presented with complaints of low back pain and right buttock pain while pitching. A diagnosis of foraminal stenosis caused by a disc bulge combined with facet hypertrophy contralateral to the dominant hand was made on the basis of physical and radiological findings. His symptoms improved immediately after transforaminal full-endoscopic lumbar discectomy and foraminoplasty under local anesthesia. He returned to play 3 months after surgery. Foraminal stenosis due to facet hypertrophy may occur in the side contralateral to the throwing arm in pitchers. Minimally invasive decompression using a full-endoscopic procedure is required for high-level athletes at this position.
背痛和下肢疼痛有多种病因，偶尔会同时出现，造成诊断困难。此外，运动员在治疗方面需要特殊考虑。在此，我们报告一例因腰椎间盘突出合并小关节肥大导致的椎间孔狭窄病例，该病例发生在一名棒球投手优势手对侧，通过微创全内镜手术成功治愈。一名31岁的左撇子男性棒球投手在投球时出现腰痛和右臀部疼痛。根据体格检查和影像学检查结果，诊断为椎间盘突出合并优势手对侧小关节肥大导致的椎间孔狭窄。在局部麻醉下进行经椎间孔全内镜腰椎间盘切除术和椎间孔成形术后，他的症状立即得到改善。术后3个月他重返赛场。投手投球手臂对侧可能会出现因小关节肥大导致的椎间孔狭窄。对于处于该位置的高水平运动员，需要采用全内镜手术进行微创减压。
