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针对黄韧带肥厚所致颈椎管狭窄患者采用单侧入路的半椎板切除术及双侧黄韧带切除术技术:技术说明

Hemipartial Laminectomy and Bilateral Flavectomy Technique With Unilateral Approach in Patients With Cervical Spinal Stenosis Due to Ligamentum Flavum Hypertrophy: A Technique Note.

作者信息

Senturk Salim, Ünsal Ülkün, Çevik Serdar, Yaman Onur

机构信息

Neurosurgery, Memorial Spina Center, Istanbul, TUR.

Neurosurgery, Manisa Şehir Hospital, Manisa, TUR.

出版信息

Cureus. 2021 Nov 30;13(11):e20040. doi: 10.7759/cureus.20040. eCollection 2021 Nov.

Abstract

The aim of this procedure is to widen the spinal canal by using minimally invasive techniques to do hemipartial laminectomy and bilateral flavectomy in patients with cervical spinal stenosis due to ligamentum flavum hypertrophy. A 66-year-old man presented with increasing neck and right shoulder pain for one year to Koç University Hospital. He reported a three-month history of numbness in his hands. The Japanese Orthopedic Association (JOA) and Visual Analogue Scale (VAS) scores were 15 and 8, respectively. Preoperative magnetic resonance imaging (MRI) revealed spinal canal stenosis at the C3-4 level secondary to ligamentum flavum hypertrophy. Hemi-partial laminectomy at the C3 level, flavectomy, and bilateral decompression were performed using the right unilateral approach. The patient's complaints of symptoms considerably decreased three months later. The VAS and JOA scores were 2 and 16, respectively. This minimally invasive approach can be an alternative to classic laminectomy in patients who have radiculopathy and myelopathy due to posterior origin spinal stenosis in order to safely resolve pain and neurologic dysfunction.

摘要

该手术的目的是通过微创技术对因黄韧带肥厚导致颈椎管狭窄的患者进行半椎板切除术和双侧黄韧带切除术,以扩大椎管。一名66岁男性因颈部和右肩部疼痛加重一年就诊于科克大学医院。他自述双手麻木已有三个月。日本骨科协会(JOA)评分和视觉模拟量表(VAS)评分分别为15分和8分。术前磁共振成像(MRI)显示C3-4水平因黄韧带肥厚继发椎管狭窄。采用右侧单边入路在C3水平进行半椎板切除术、黄韧带切除术和双侧减压术。三个月后,患者的症状主诉明显减轻。VAS评分和JOA评分分别为2分和16分。对于因后路源性椎管狭窄导致神经根病和脊髓病的患者,这种微创方法可以作为经典椎板切除术的替代方案,以便安全地缓解疼痛和神经功能障碍。

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