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全内镜下脊柱手术治疗骨质疏松性椎体压缩骨折后腰椎椎间孔狭窄:一例报告。

Full-endoscopic spine surgery treatment of lumbar foraminal stenosis after osteoporotic vertebral compression fractures: A case report.

作者信息

Zhao Quan-Lai, Hou Kun-Peng, Wu Zhong-Xuan, Xiao Liang, Xu Hong-Guang

机构信息

Department of Spine Surgery, Wannan Medical College, Wuhu 241001, Anhui Province, China.

出版信息

World J Clin Cases. 2022 Jan 14;10(2):656-662. doi: 10.12998/wjcc.v10.i2.656.

Abstract

BACKGROUND

Few reports have described lumbar foraminal stenosis-induced radiculopathy after treatment by full-endoscopic spine surgery (FESS) combined with percutaneous vertebroplasty (PVP) in patients with vertebral compression fractures. We herein report such a case, including the patient's treatment process and doctor's surgical experience.

CASE SUMMARY

A 79-year-old man presented with symptoms of radiculopathy after sustaining L4 vertebral compression fractures. Imaging and physical examination revealed L4 vertebral compression fractures combined with L3/4 Lumbar foraminal stenosis (LFS). The patient's symptoms were low back pain with pain in the lateral left leg. Although many reports have described radiculopathy induced by osteoporotic vertebral compression fractures, the use of FESS combined with PVP has rarely been reported. This case report indicates that the combination of FESS and PVP is a safe and effective approach for the treatment of LFS-induced radiculopathy after vertebral compression fractures. This minimally invasive technique has great potential to replace traditional lumbar fixation and decompression surgery. Thus, we suggest the continued accumulation of similar cases to discuss the wider application of FESS.

CONCLUSION

For patients with osteoporotic vertebral compression fracture (OVCF) and LFS, PVP and FESS can be used to restore the vertebral height and reduce the pressure around the intervertebral foramen. Additionally, the combination of FESS and PVP can treat the pain or numbness of the low back and lower limbs and allow for recovery in a short time with excellent postoperative effects. In general, FESS is a good treatment for radiculopathy caused by foraminal stenosis after OVCF.

摘要

背景

很少有报告描述在椎体压缩骨折患者中,经全内镜脊柱手术(FESS)联合经皮椎体成形术(PVP)治疗后出现腰椎椎间孔狭窄引起的神经根病。我们在此报告这样一例病例,包括患者的治疗过程和医生的手术经验。

病例摘要

一名79岁男性在发生L4椎体压缩骨折后出现神经根病症状。影像学和体格检查显示L4椎体压缩骨折合并L3/4腰椎椎间孔狭窄(LFS)。患者的症状为腰痛伴左下肢外侧疼痛。尽管有许多报告描述了骨质疏松性椎体压缩骨折引起的神经根病,但FESS联合PVP的应用很少被报道。本病例报告表明,FESS和PVP联合应用是治疗椎体压缩骨折后LFS引起的神经根病的一种安全有效的方法。这种微创技术有很大潜力取代传统的腰椎固定和减压手术。因此,我们建议继续积累类似病例,以探讨FESS更广泛的应用。

结论

对于骨质疏松性椎体压缩骨折(OVCF)合并LFS的患者,PVP和FESS可用于恢复椎体高度并减轻椎间孔周围压力。此外,FESS和PVP联合应用可治疗腰背部和下肢的疼痛或麻木,并能在短时间内恢复,术后效果良好。总体而言,FESS是治疗OVCF后椎间孔狭窄引起的神经根病的一种良好方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39f3/8771379/05faca89fe84/WJCC-10-656-g001.jpg

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