Ma Hyun-Jin, Lee Sang-Ho, Park Chan Hong
Departments of1Neurosurgery and.
2Department of Neurosurgery, Wooridul Spine Hospital, Seoul, Korea.
J Neurosurg Case Lessons. 2023 May 29;5(22). doi: 10.3171/CASE2378.
Endoscopic decompression for cervical stenotic myelopathy has several advantages over conventional open surgery. However, sometimes performing bilateral decompression, especially contralateral decompression, can be dangerous. The cervical spine has specific characteristics, including a shallower lamina angle and thinner lamina than the lumbar or thoracic lamina. These characteristics may cause cord compression when instruments approach the contralateral side of the lamina. This article introduces a novel surgical technique that can overcome the specificities of the cervical spine and discusses the efficacy and safety of uniportal full endoscopy for cervical decompression.
Fourteen patients underwent uniportal full endoscopic spinous process-preserving laminectomy (ESP-L) for bilateral decompression of multilevel cervical stenotic myelopathy. The mean follow-up period was 13.44 months (range: 4-17 months). The preoperative and postoperative cervical spine angle and cervical range of motion did not differ significantly. The Japanese Orthopaedic Association score significantly improved postoperatively. The numeric rating scale scores significantly improved postoperatively. The mean duration of postoperative hospitalization was 2.3 days.
ESP-L is a new, safe, effective, and noninvasive technique that can achieve complete decompression of multilevel cervical stenotic myelopathy.
与传统开放手术相比，内镜下减压治疗颈椎管狭窄症性脊髓病具有多个优势。然而，有时进行双侧减压，尤其是对侧减压，可能会很危险。颈椎具有特定特征，包括椎板角度比腰椎或胸椎椎板更浅、椎板更薄。当器械靠近椎板对侧时，这些特征可能导致脊髓受压。本文介绍一种可克服颈椎特异性的新型手术技术，并探讨单孔全内镜下颈椎减压的疗效和安全性。
14例患者接受了单孔全内镜下保留棘突椎板切除术（ESP-L），用于多节段颈椎管狭窄症性脊髓病的双侧减压。平均随访期为13.44个月（范围：4 - 17个月）。术前和术后颈椎角度及颈椎活动范围无显著差异。日本骨科协会评分术后显著改善。数字评定量表评分术后显著改善。术后平均住院时间为2.3天。
ESP-L是一种新的、安全、有效的无创技术，可实现多节段颈椎管狭窄症性脊髓病的完全减压。
