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颈胸段脊柱的内镜脊柱手术:当前应用综述

Endoscopic Spine Surgery of the Cervicothoracic Spine: A Review of Current Applications.

作者信息

Shen Jian, Shaaya Elias, Bae Junseok, Telfeian Albert E

机构信息

Shen-Spine, New York, New York.

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

出版信息

Int J Spine Surg. 2021 Dec;15(suppl 3):S93-S103. doi: 10.14444/8168.

Abstract

BACKGROUND

Endoscopic spine surgery in the cervicothoracic spine is generating continued interest in a rapidly evolving field. The authors present 4 techniques for fully endoscopic cervical spine surgery: (1) posterior cervical unilateral laminectomy and bilateral decompression, (2) posterior cervical foraminotomy, (3) anterior cervical discectomy, and (4) anterior transcorporal discectomy. Two techniques for fully endoscopic thoracic spine surgery are also presented: (1) posterior thoracic unilateral laminectomy and bilateral decompression and (2) transforaminal thoracic endoscopic discectomy and foraminotomy.

METHODS

We describe 6 different surgical approaches and review the relevant literature about each technique.

RESULTS

The clinical application of endoscopic spine surgery techniques has evolved over the past 40 years. Recent data suggest comparable outcomes to other procedures and perhaps fewer complications and quicker recovery when these techniques are used in the cervical and thoracic spine. Significant variability exists in these approaches depending on the goal of canal decompression, root decompression, and the site of the pathology.

CONCLUSIONS

Each endoscopic approach in the cervicothoracic spine has its technical nuances, outcomes, advantages, and disadvantages, making fully endoscopic cervicothoracic spine surgery an exciting and growing field.

摘要

背景

颈椎胸椎的内镜脊柱手术在这个快速发展的领域中持续引发关注。作者介绍了4种全内镜颈椎手术技术:(1)颈椎后路单侧椎板切除术及双侧减压术,(2)颈椎后路椎间孔切开术,(3)颈椎前路椎间盘切除术,以及(4)颈椎前路经椎体椎间盘切除术。还介绍了2种全内镜胸椎手术技术:(1)胸椎后路单侧椎板切除术及双侧减压术,以及(2)经椎间孔胸椎内镜椎间盘切除术及椎间孔切开术。

方法

我们描述了6种不同的手术入路,并回顾了每种技术的相关文献。

结果

内镜脊柱手术技术的临床应用在过去40年中不断发展。近期数据表明,当这些技术应用于颈椎和胸椎时,其结果与其他手术相当,且并发症可能更少、恢复更快。根据椎管减压、神经根减压的目标以及病变部位的不同,这些手术入路存在显著差异。

结论

颈椎胸椎的每种内镜手术入路都有其技术细节、结果、优点和缺点,这使得全内镜颈椎胸椎手术成为一个令人兴奋且不断发展的领域。

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本文引用的文献

1
Full endoscopic surgery for thoracic pathology: an assessment of supportive evidence.胸科疾病的全胸腔镜手术:支持证据评估
EFORT Open Rev. 2021 Jan 4;6(1):50-60. doi: 10.1302/2058-5241.6.200080. eCollection 2021 Jan.
6
Full endoscopic cervical spine surgery.全内镜下颈椎手术。
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