经皮内镜椎间孔入路椎间盘切除术术后症状性椎间盘假性囊肿：病例报告及文献复习。
Symptomatic Postoperative Discal Pseudocyst After Percutaneous Endoscopic Interlaminar Discectomy: Case Report and Literature Review.
机构信息
Department of Orthopaedics, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Pathology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
出版信息
Orthop Surg. 2021 Feb;13(1):347-352. doi: 10.1111/os.12863. Epub 2020 Dec 16.
BACKGROUND
A postoperative discal pseudocyst (PDP) is a cystic lesion that is formed in the operation area of the intervertebral disc, leading to recurrence or even worse symptoms. To our knowledge, to date, there is no research focusing specifically on PDP following percutaneous endoscopic interlaminar discectomy (PEID).
CASE PRESENTATION
We present the case of a 27-year-old man with L S intervertebral disc herniation who was treated with PEID after failed conservative treatment. His leg pain was relieved immediately but reoccurred on the 40th day. MRI showed a PDP. Because loxoprofen and bedrest were ineffective and the patient was anxious, we performed a cystectomy. The patient's symptoms were significantly relieved, and a 6-month follow up showed no recurrence both clinically and on MRI.
CONCLUSION
A PDP is more likely to form using the interlaminar approach than the transforaminal approach. For patients with mental stress, severe pain, and neurological symptoms, surgery is suggested to remove the cyst. Discectomy cannot be performed when disc degeneration is mild.
背景
术后椎间盘假性囊肿（PDP）是一种在椎间盘手术区域形成的囊性病变，可导致复发甚至更严重的症状。据我们所知，迄今为止，尚无专门针对经皮内镜椎间孔入路椎间盘切除术（PEID）后 PDP 的研究。
病例介绍
我们报告了 1 例 27 岁男性 L₅S₁椎间盘突出症患者，经保守治疗失败后接受 PEID 治疗。他的腿痛立即缓解，但在第 40 天再次出现。MRI 显示 PDP。由于洛索洛芬和卧床休息无效，且患者焦虑，我们进行了囊肿切除术。患者的症状明显缓解，6 个月的随访显示 MRI 未见复发，临床症状也无复发。
结论
与经椎间孔入路相比，经皮内镜椎间孔入路更容易形成 PDP。对于精神压力大、疼痛剧烈、有神经症状的患者，建议手术切除囊肿。当椎间盘退变程度较轻时，不能进行椎间盘切除术。
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