Ju Chang Il, Lee Seung Myung
Department of Neurosurgery, College of Medicine, Chosun University, Gwangju, Korea.
Neurospine. 2023 Mar;20(1):56-77. doi: 10.14245/ns.2346226.113. Epub 2023 Mar 31.
In the past, the use of endoscopic spine surgery was limited to intervertebral discectomy; however, it has recently become possible to treat various spinal degenerative diseases, such as spinal stenosis and foraminal stenosis, and the treatment range has also expanded from the lumbar spine to the cervical and thoracic regions. However, as endoscopic spine surgery develops and its indications widen, more diverse and advanced surgical techniques are being introduced, and the complications of endoscopic spine surgery are also increasing accordingly. We searched the PubMed/MEDLINE databases to identify articles on endoscopic spinal surgery, and key words were set as "endoscopic spinal surgery," "endoscopic cervical foramoinotomy," "PECD," "percutaneous transforaminal discectomy," "percutaneous endoscopic interlaminar discectomy," "PELD," "PETD," "PEID," "YESS" and "TESSYS." We analyzed the evidence level and classified the prescribed complications according to the literature. Endoscopic lumbar surgery was divided into full endoscopic interlaminar and transforaminal approaches and a unilateral biportal approach. We performed a comprehensive review of available literature on complications of endoscopic spinal surgery. This study particularly focused on the prevention of complications. Regardless of the surgical methods, the most common complications related to endoscopic spinal surgery include dural tears and perioperative hematoma. transient dysesthesia, nerve root injury and recurrence. However, Endoscopic spinal surgery, including full endoscopic transforaminal and interlaminar and unilateral biportal approaches, is a safe and effective a treatment for lumbar as well as cervical and thoracic spinal diseases such as disc herniation, lumbar spinal stenosis, foraminal stenosis and recurrent disc herniation.
过去，脊柱内镜手术仅限于椎间盘切除术；然而，最近已经能够治疗各种脊柱退行性疾病，如椎管狭窄和椎间孔狭窄，并且治疗范围也已从腰椎扩展到颈椎和胸椎区域。然而，随着脊柱内镜手术的发展及其适应证的扩大，越来越多不同且先进的手术技术被引入，脊柱内镜手术的并发症也相应增加。我们检索了PubMed/MEDLINE数据库以识别关于脊柱内镜手术的文章，关键词设定为“脊柱内镜手术”“内镜下颈椎椎间孔切开术”“经皮内镜下颈椎间盘切除术（PECD）”“经皮椎间孔椎间盘切除术”“经皮内镜下椎板间椎间盘切除术”“经皮内镜腰椎间盘切除术（PELD）”“经皮内镜下经椎间孔椎间盘切除术（PETD）”“经皮内镜下椎间孔入路椎间盘切除术（PEID）”“杨氏内镜脊柱系统（YESS）”和“全内镜脊柱椎间孔扩大减压技术（TESSYS）”。我们分析了证据水平，并根据文献对规定的并发症进行分类。内镜下腰椎手术分为全内镜椎板间和椎间孔入路以及单侧双通道入路。我们对脊柱内镜手术并发症的现有文献进行了全面综述。本研究特别关注并发症的预防。无论手术方法如何，与脊柱内镜手术相关的最常见并发症包括硬脊膜撕裂、围手术期血肿、短暂性感觉异常、神经根损伤和复发。然而，包括全内镜椎间孔和椎板间入路以及单侧双通道入路在内的脊柱内镜手术，对于腰椎以及颈椎和胸椎的脊柱疾病，如椎间盘突出症、腰椎管狭窄症、椎间孔狭窄症和复发性椎间盘突出症，是一种安全有效的治疗方法。
