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内镜脊柱手术治疗外侧和斜向融合相关的四种并发症:技术说明和病例系列。

Four Complications Associated with Lateral and Oblique Fusion Treatable with Endoscopic Spine Surgery: Technical Note and Case Series.

机构信息

The Warren Alpert Medical School of Brown University, Providence, RI.

Department of Neurosurgery, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI.

出版信息

Pain Physician. 2020 Nov;23(6):E665-E671.

Abstract

BACKGROUND

The lateral fusion procedure is a newer minimally invasive approach to indirectly decompressing and fusing a lumbar motion segment. As with many new procedures, new thoughtful approaches to recognizing and treating the complications of these procedures need to be developed.

OBJECTIVES

Here we describe our experience with transforaminal endoscopic decompression for complications of lateral and oblique lumbar fusion.

STUDY DESIGN

Retrospective case review.

SETTING

This was a multicenter study that took place in an academic hospital, community hospital, and ambulatory surgery center.

METHODS

An endoscopic treatment technique for 4 types of complications associated with lateral and oblique fusion is presented. We retrospectively reviewed cases at 3 centers in 2 countries of patients who underwent transforaminal endoscopic surgery for the treatment of lateral fusion complications in a 4-year period with a minimum follow-up of 1 year.

RESULTS

A preliminary series of 4 patients with an average age of 74.8 years (range, 69-82 years) who underwent transforaminal endoscopic procedures at the level of their lateral and oblique lumbar fusions between 2014 and 2018 is presented. Disc herniations, heterotopic bone formation, endplate fracture, and nerve root impingement by the interbody device were all treated endoscopically.

LIMITATIONS

Small case series evaluated retrospectively with 1-year follow-up.

CONCLUSIONS

Transforaminal endoscopic surgery is a useful minimally invasive surgical technique to treat several complications associated with lateral and oblique lumbar interbody fusion procedures.

摘要

背景

侧方融合术是一种较新的微创方法,可间接对腰椎运动节段进行减压和融合。与许多新手术一样,需要开发新的、有思想的方法来识别和治疗这些手术的并发症。

目的

本研究介绍了我们经椎间孔内窥镜减压治疗侧方和斜侧腰椎融合术并发症的经验。

研究设计

回顾性病例研究。

设置

这是一项多中心研究,在一家学术医院、社区医院和日间手术中心进行。

方法

介绍了 4 种与侧方和斜侧融合相关的并发症的内镜治疗技术。我们回顾了 2014 年至 2018 年间在两国 3 个中心接受经椎间孔内窥镜手术治疗侧方融合并发症的患者的病例,随访时间至少为 1 年。

结果

我们初步报告了 4 例平均年龄 74.8 岁(范围 69-82 岁)的患者,他们在 2014 年至 2018 年间在侧方和斜侧腰椎融合水平接受了经椎间孔内窥镜手术。均经内镜治疗椎间盘突出、异位骨化、终板骨折和椎间融合器对神经根的压迫。

局限性

小病例系列,回顾性评估,随访时间 1 年。

结论

经椎间孔内窥镜手术是一种有用的微创外科技术,可治疗与侧方和斜侧腰椎体间融合术相关的多种并发症。

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