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一种用于治疗高度向下移位腰椎间盘突出症的经椎弓根入路全内镜技术的新轨迹。

A Novel Trajectory for a Transpedicular Approach in the Treatment of a Highly Downward-Migrated Lumbar Herniation with a Full Endoscopic Technique.

作者信息

Jiang Yi, Zuo Rujun, Yuan Shuai, Li Jian, Liu Chang, Zhang Jiexun, Ma Ming

机构信息

Department of Orthopedics (Minimally Invasive Spine Surgery Branch), Beijing Haidian Hospital (Haidian Section of Peking University Third Hospital), Beijing, China.

出版信息

Front Surg. 2022 May 17;9:915052. doi: 10.3389/fsurg.2022.915052. eCollection 2022.

DOI:10.3389/fsurg.2022.915052
PMID:35656083
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9152169/
Abstract

BACKGROUND

To evaluate the clinical outcome of full endoscopic discectomy using a novel trajectory a transpedicular approach.

METHOD

Thirty-five patients were enrolled in this retrospective study between July 2014 and October 2019 in the Beijing Haidian Hospital. All patients were treated with full-endoscopic lumbar discectomy a transpedicular approach with an oblique trajectory. The imaging parameters, including pedicle height and angle of trajectory, were recorded. The preoperative and postoperative clinical data were collected for statistical analysis.

RESULTS

All patients underwent successful surgery without severe complications. We compared the visual analogue scale and Oswestry disability index scores before and after surgery. The differences were statistically significant ( < 0.05). According to the modified Macnab criteria, the good-to-excellent rate was 85.7% at the last follow-up. The average angles of trajectory in the sagittal and coronal planes were 34.5° ± 2.9° and 47.1° ± 5.0°, respectively.

CONCLUSION

The new trajectory of the transpedicular approach with a full endoscopic technique for an extremely downward-migrated disc herniation showed excellent results in a small sample study. A precise surgical plan is required, comprising measurements of the pedicle height and angle of the bone tunnel.

摘要

背景

为评估采用新型经椎弓根入路轨迹的全内镜下椎间盘切除术的临床疗效。

方法

2014年7月至2019年10月期间，北京海淀医院对35例患者进行了这项回顾性研究。所有患者均接受了全内镜下腰椎间盘切除术，采用经椎弓根斜行轨迹入路。记录包括椎弓根高度和轨迹角度在内的影像学参数。收集术前和术后临床数据进行统计分析。

结果

所有患者手术均成功，无严重并发症。比较了手术前后的视觉模拟评分和Oswestry功能障碍指数评分。差异具有统计学意义（<0.05）。根据改良Macnab标准，末次随访时优良率为85.7%。矢状面和冠状面的平均轨迹角度分别为34.5°±2.9°和47.1°±5.0°。

结论

在一项小样本研究中，采用全内镜技术的经椎弓根入路新轨迹治疗极低位椎间盘突出症显示出优异的效果。需要制定精确的手术计划，包括测量椎弓根高度和骨隧道角度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f6c/9152169/e9e7f17944b0/fsurg-09-915052-g014.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f6c/9152169/76ce94a43ca7/fsurg-09-915052-g011.jpg
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[Two treatment approaches for lumbar disc herniation and sequester migration to the second and third McCulloch's windows: transpedicular and translaminar sequestrectomy (ridit analysis)].[腰椎间盘突出症及游离髓核移位至麦卡洛第二和第三窗的两种治疗方法：经椎弓根和经椎板髓核摘除术（ridit分析）]
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The Trans-Superior Articular Process Approach Utilizing Visual Trephine: A More Time-Saving and Effective Percutaneous Endoscopic Transforaminal Lumbar Discectomy for Migrated Lumbar Disc Herniation.
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