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颈椎内镜脊柱手术的现状:最新文献回顾与技术考虑。

The Current State of Cervical Endoscopic Spine Surgery: an Updated Literature Review and Technical Considerations.

机构信息

Department of Neurosurgery, Gil Medical Center, Gachon University College of Medicine , Incheon, South Korea.

出版信息

Expert Rev Med Devices. 2020 Dec;17(12):1285-1292. doi: 10.1080/17434440.2020.1853523. Epub 2020 Dec 30.

Abstract

: Endoscopic spine surgery has become one of the representative minimally invasive spine surgeries (MISS), especially in the lumbar spine. Full-endoscopic procedures using a working channel endoscope for cervical degenerative spine disease have been reported as practical and feasible. This review aimed to summarize the updated techniques of and studies about cervical endoscopic surgery. : An extensive search of PubMed was performed for randomized controlled trials (RCTs) or comparative cohort studies on the full-endoscopic cervical procedure. All the 236 articles found were screened and categorized. Only two RCTs and four cohort studies finally met the search criteria. Regarding the surgical techniques, there are four categories according to the approach method: 1) anterior endoscopic cervical discectomy (AECD); 2) anterior endoscopic cervical transcorporeal decompression (AECTcD); 3) posterior endoscopic cervical foraminotomy and discectomy (PECFD); and 4) posterior endoscopic cervical laminotomy (PECL). : Cervical endoscopic surgery provides comparable clinical results with MISS benefits, such as shorter operative time, less bleeding, and earlier recovery time. However, spine surgeons are not yet familiar with most of these techniques; moreover, supportive evidence is minimal. Technical evolution is still ongoing in an effort to make the procedure more practical.

摘要

: 内镜脊柱手术已成为微创脊柱手术 (MISS) 的代表之一,尤其在腰椎方面。对于颈椎退行性脊柱疾病,采用工作通道内镜进行全内镜手术已被证明具有实用性和可行性。本综述旨在总结颈椎内镜手术的最新技术和研究进展。: 对 PubMed 进行了广泛搜索,以查找关于全内镜颈椎手术的随机对照试验 (RCT) 或对照队列研究。对找到的 236 篇文章进行了筛选和分类。最终只有两项 RCT 和四项队列研究符合搜索标准。关于手术技术,根据入路方法可分为四类:1) 前路内镜颈椎间盘切除术 (AECD);2) 前路内镜经椎体减压术 (AECTcD);3) 后路内镜颈椎侧方减压术和椎间盘切除术 (PECFD);和 4) 后路内镜颈椎椎板切除术 (PECL)。: 颈椎内镜手术提供了与 MISS 益处相当的临床效果,例如手术时间更短、出血量更少、恢复时间更早。然而,大多数脊柱外科医生还不熟悉这些技术,而且支持证据也很少。为了使手术更实用,技术仍在不断发展。

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