Hagihara Shintaro, Nakagawa Masayuki, Matsubara Kana, Godai Kohei, Kamijima Kenya, Abe Yoichiro
Department of Anesthesiology and Pain Medicine, Kagoshima University Hospital, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.
Department of Pain Clinic, NTT Medical Center Tokyo, 5-9-22 Higashigotanda, Shinagawa, Tokyo, 141-8625, Japan.
JA Clin Rep. 2022 Aug 13;8(1):63. doi: 10.1186/s40981-022-00554-z.
Complex anatomical features are challenging for minimally invasive intradiscal therapy owing to insufficient visualization for accurate needle advancement. We report the case of a patient with dysraphic vertebral pathologies who presented with L5/S1 degeneration and was successfully treated with annuloplasty using the cone-beam computed tomography (CBCT)-assisted radiofrequency thermocoagulation system.
A 34-year-old woman presented with a lower back and left radicular pain of L5/S1 discogenic origin, accompanied by spina bifida occulta and lumbosacral transitional vertebra. Radiofrequency annuloplasty was performed to preserve disc height and spinal stability, with real-time CBCT guidance for the congenital and degenerative conditions. The procedure relieved her left lower-extremity pain and magnetic resonance imaging revealed that the L5/S1 disc bulging decreased while the disc height was preserved.
Optimal accessibility of radiofrequency thermocoagulation and effective needle guidance using CBCT significantly improve the success rate of annuloplasty at the L5/S1 degenerative disc with severe vertebral deformity.
复杂的解剖结构对微创椎间盘内治疗构成挑战，因为在准确进针时可视化不足。我们报告了一例患有脊柱裂畸形的患者，该患者出现L5/S1退变，并使用锥形束计算机断层扫描（CBCT）辅助射频热凝系统成功进行了瓣环成形术治疗。
一名34岁女性因L5/S1椎间盘源性下背部和左神经根性疼痛就诊，伴有隐性脊柱裂和腰骶部移行椎。为保留椎间盘高度和脊柱稳定性进行了射频瓣环成形术，对先天性和退行性疾病采用实时CBCT引导。该手术缓解了她的左下肢疼痛，磁共振成像显示L5/S1椎间盘膨出减少，同时椎间盘高度得以保留。
射频热凝的最佳可达性以及使用CBCT进行有效的针引导，显著提高了在严重椎体畸形的L5/S1退变椎间盘处进行瓣环成形术的成功率。
