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经椎间孔内镜下椎间盘切除术治疗大型、两节段钙化型胸椎间盘突出症并随访5年

Transforaminal Endoscopic Discectomy for Large, Two Level Calcified, Thoracic Disc Herniations With 5-Year Follow-up.

作者信息

Houra Karlo, Saftic Robert

机构信息

Aksis - Specialty Hospital for Neurosurgery and Orthopedic Surgery, Zagreb, Croatia.

University North, University Center Varazdin, Varazdin, Croatia.

出版信息

Neurospine. 2020 Dec;17(4):954-959. doi: 10.14245/ns.2040090.045. Epub 2020 Dec 31.

Abstract

To describe technical details and benefits of transforaminal endoscopic discectomy for treatment of patients with large, dorsomedial, calcified thoracic disc herniations at 2 levels and to report on their clinical outcomes in long follow-up period of 5 years using 4 different outcome tools. We present 2 patients with large, calcified disc herniations at 2 levels in mid and lower thoracic spine treated endoscopically in local anesthesia. Clinical outcomes were analyzed using verbal numeric scale (VNS), Roland-Morris low back pain and disability questionnaire (RMQ), Oswestry Disability Index (ODI), and modified MacNab criteria at 6-, 12-, 24-, 60-month follow-up. After transforaminal endoscopic discectomy, both patients had significant postoperative reduction of back pain using VNS and significant outcome improvement using ODI, RMQ score, and modified MacNab criteria. These results did not change during all 4 follow-up periods. Transforaminal percutaneous full-endoscopic discectomy and hand reamers foraminotomy in local anesthesia is feasible and effective surgical technique for patients with large, calcified thoracic disc herniations at 2 levels even in long follow-up period of 5 years using 4 different outcome measuring tools. All 3 outcome measuring tools correlated well with pain reduction using VNS.

摘要

描述经椎间孔内镜下椎间盘切除术治疗两节段巨大、背内侧钙化型胸椎间盘突出症患者的技术细节和益处,并使用4种不同的疗效评估工具报告其5年长期随访的临床结果。我们报告2例在胸段脊柱中下部存在两节段巨大钙化型椎间盘突出症的患者,在局部麻醉下接受了内镜治疗。在6个月、12个月、24个月和60个月的随访中,使用言语数字评分量表(VNS)、罗兰-莫里斯下腰痛与功能障碍问卷(RMQ)、奥斯威斯功能障碍指数(ODI)和改良MacNab标准对临床结果进行分析。经椎间孔内镜下椎间盘切除术后,两名患者使用VNS评估术后背痛均显著减轻,使用ODI、RMQ评分和改良MacNab标准评估疗效均显著改善。在所有4个随访期内,这些结果均未改变。对于两节段巨大钙化型胸椎间盘突出症患者,局部麻醉下经椎间孔经皮全内镜下椎间盘切除术和手动扩孔钻开椎间孔术是一种可行且有效的手术技术,即使在5年的长期随访中使用4种不同的疗效测量工具也是如此。所有3种疗效测量工具与使用VNS评估的疼痛减轻均具有良好的相关性。

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