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经椎间孔外途径治疗远外侧型椎间盘突出症的临床经验:132 例报告。

Clinical experience on intertransverse extraforaminal approach for far lateral disc herniations: 132 cases.

机构信息

Department of Neurosurgery, Medical Faculty of Amasya, Turkey.

出版信息

Niger J Clin Pract. 2022 May;25(5):630-635. doi: 10.4103/njcp.njcp_1588_21.

Abstract

BACKGROUND

Far lateral disc herniations attract many spine surgeons for their type of onset, degree of pain, risk of neurological deficit, and increasing incidence. Today, a direct approach to the region by miminally invasive techniques is preferred.

AIMS

We aimed to present the results of the cases that were operated via intertransverse extraforaminal approach through a midline incision.

PATIENTS AND METHODS

One hundred thirty-two patients who were operated for far lateral disc herniation by extraforaminal approach between January 2010 and December 2017 were retrospectively evaluated. The demographical data, level of disc herniations, examination findings, preoperative and postoperative VAS scores, and postoperative long-term MacNab satisfaction rates were recorded.

RESULTS

Sixty-nine of the patients were male. The mean age was 58.1 years. Acute onset pain was a dominant complaint in 75% of the cases. The mean preoperative VAS score of 8.24 decreased to 2.08 at one month postoperatively. Based on a mean follow-up of 34.4 months, the long-term satisfaction rates according to Macnab criteria were 74% excellent-good, 20% moderate, and 6% poor.

CONCLUSION

Intertransverse extraforaminal approach is an effective and safe technique for far lateral disc herniations. However, considering the anatomical restrictions and the unfamiliarity of the surgeons with the region, it is important that the surgeons perform the surgery with the technique they know best to increase the success of the surgery.

摘要

背景

远外侧椎间盘突出因其发病类型、疼痛程度、发生风险和发病率的增加而引起许多脊柱外科医生的关注。如今,微创技术直接进入该区域是首选方法。

目的

我们旨在展示通过中线切口经椎间孔外途径手术的病例结果。

患者与方法

回顾性分析 2010 年 1 月至 2017 年 12 月期间通过椎间孔外途径对 132 例远外侧椎间盘突出症患者进行手术的情况。记录了患者的人口统计学数据、椎间盘突出程度、检查结果、术前和术后视觉模拟评分(VAS)以及术后长期 MacNab 满意度。

结果

69 例患者为男性,平均年龄为 58.1 岁。75%的病例以急性发作性疼痛为主诉。术前平均 VAS 评分为 8.24,术后 1 个月降至 2.08。平均随访 34.4 个月后,根据 Macnab 标准,长期满意度为 74%优秀-良好,20%中等,6%差。

结论

经椎间孔外途径是治疗远外侧椎间盘突出症的有效且安全的技术。然而,考虑到解剖学限制和外科医生对该区域的不熟悉,外科医生使用他们最熟悉的技术进行手术以提高手术成功率非常重要。

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