Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India.
Department of Spine Surgery, Madras Medical College, Chennai, Tamil Nadu, India.
Neurol India. 2022 Mar-Apr;70(2):510-514. doi: 10.4103/0028-3886.344669.
BACKGROUND AND INTRODUCTION: Minimally invasive spine surgery (MISS) is a set of techniques and procedures that reduces the local tissue injury while achieving the same results through traditional open surgery. The techniques for the treatment of lumbar disc herniation and degenerative canal stenosis have evolved from tubular discectomy to endoscopic discectomy. This helps in preserving spine function. Good clinical outcomes have been reported with the use of an endoscope for degenerative lumbar disc disease. OBJECTIVE: In this video abstract, we present a case lumbar foraminal stenosis in an elderly man that was treated successfully using unilateral biportal endoscopic spine surgery. (UBESS). SURGICAL TECHNIQUE: A 70-year-old man presented with progressive neurogenic claudication and left L4 numbness and paresthesias. His claudication distance was 200 m. His MRI Lumbosacral spine showed severe left L4-5 foraminal stenosis due to a disc prolapse. The patient underwent a left-sided unilateral biportal endoscopic transforaminal decompression and discectomy at L4-5 successfully. Postoperative period was uneventful and the patient had significant relief in his symptoms. Postoperative MRI Lumbosacral spine showed no muscle damage with adequate decompression at left L4-5 level. RESULTS: The patient had an uneventful recovery. CONCLUSION: Biportal percutaneous transforaminal endoscopic discectomy/decompression is an ideal alternative to the uniportal endoscopic and minimal invasive microsurgery for foraminal and paracentral disc herniations and lateral recess and foraminal stenosis.
背景与介绍:微创脊柱外科(MISS)是一组技术和程序,通过传统的开放手术实现相同的结果,同时减少局部组织损伤。治疗腰椎间盘突出症和退行性椎管狭窄症的技术已从管状椎间盘切除术发展为内窥镜椎间盘切除术。这有助于保持脊柱功能。使用内窥镜治疗退行性腰椎疾病已报告了良好的临床结果。
目的:在这个视频摘要中,我们展示了一例老年男性腰椎侧隐窝狭窄的病例,该患者成功地接受了单侧双通道内镜脊柱外科手术(UBESS)治疗。
手术技术:一名 70 岁男性出现进行性神经性跛行和左侧 L4 麻木和感觉异常。他的跛行距离为 200 米。他的腰椎 MRI 显示由于椎间盘突出导致严重的左侧 L4-5 椎间孔狭窄。患者成功地接受了左侧单侧双通道内镜经椎间孔减压和椎间盘切除术。术后恢复顺利,患者症状明显缓解。腰椎 MRI 显示术后无肌肉损伤,左侧 L4-5 水平减压充分。
结果:患者恢复顺利。
结论:双通道经皮椎间孔内窥镜椎间盘切除术/减压术是治疗椎间孔和旁中央椎间盘突出症以及侧隐窝和椎间孔狭窄的单通道内窥镜和微创显微手术的理想替代方法。
Clin Neurol Neurosurg. 2019-10