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内窥镜辅助下 MITLIF 与透视引导技术的初步研究:椎间盘空间准备的术中客观和主观评估。

A pilot study of endoscope-assisted MITLIF with fluoroscopy-guided technique: intraoperative objective and subjective evaluation of disc space preparation.

机构信息

Department of Orthopedics, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.

Division of Neurosurgery, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan.

出版信息

BMC Surg. 2022 Mar 23;22(1):109. doi: 10.1186/s12893-022-01559-2.

Abstract

BACKGROUND

Adequate discectomy and endplate preparation are extremely crucial steps for spinal interbody fusion. Minimally invasive transforaminal lumbar interbody fusion MITLIF technique is safe and effective. However, concerns exist regarding sufficient disc space preparation from unilateral access. The purpose of this study, was to demonstrate our preliminary experience in objective and subjective evaluation of disc space preparation intraoperatively during endoscope-assisted MITLIF with fluoroscopy-guided, describing some of its possible advantages, and analyzing its safety and feasibility.

METHODS

From March 2018 to July 2019, three patients with degenerative spinal stenosis with radiculopathy and instability underwent endoscope-assisted MITLIF with fluoroscopy-guided. Patients' demographic data, clinical parameters, subsidence, and fusion were collected.

RESULTS

Patients were successfully treated by endoscope-assisted MITLIF with fluoroscopy-guided at single-level or two-level. Symptoms improved postoperatively in all patients, and no complications occurred during follow-up. No cage subsidence was observed. At 6-month postoperatively, there was bony fusion observed on computed tomography in two patients.

CONCLUSION

Endoscope-assisted MITLIF with fluoroscopy-guided is a safe and feasible technique to improve visualization during discectomy and endplate preparation objectively and subjectively, possibly increasing fusion rate and early time to fusion.

摘要

背景

充分的椎间盘切除术和终板准备对于脊柱椎间融合术至关重要。微创经椎间孔腰椎间融合术(MITLIF)技术安全有效。然而,从单侧入路充分准备椎间盘间隙仍存在一些顾虑。本研究旨在通过透视引导下的内窥镜辅助 MITLIF 术中客观和主观评估椎间盘间隙准备,展示我们的初步经验,描述其一些可能的优点,并分析其安全性和可行性。

方法

从 2018 年 3 月至 2019 年 7 月,3 名患有神经根病和不稳定的退变性脊柱狭窄症患者接受了透视引导下的内窥镜辅助 MITLIF。收集患者的人口统计学数据、临床参数、沉降和融合情况。

结果

所有患者均成功接受透视引导下的内窥镜辅助 MITLIF 治疗,单节段或双节段。所有患者术后症状均得到改善,随访期间无并发症发生。未观察到椎间笼沉降。术后 6 个月,2 例患者的 CT 检查可见骨融合。

结论

透视引导下的内窥镜辅助 MITLIF 是一种安全可行的技术,可客观和主观地改善椎间盘切除术和终板准备的可视化效果,可能提高融合率和早期融合时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f264/8944000/6e80619d7ea2/12893_2022_1559_Fig1_HTML.jpg

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