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新型 Kambin 枪钳式全内镜腰椎间融合技术:病例系列研究。

The novel Kambin Torpedo full-endoscopic lumbar interbody fusion technique: a case series.

机构信息

Department of Medical Education, MacKay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd., Zhongshan Dist, Taipei City, 104217, Taiwan.

Department of Orthopaedic Surgery, MacKay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd., Zhongshan Dist., Taipei City, 104217, Taiwan.

出版信息

Eur Spine J. 2024 Feb;33(2):417-428. doi: 10.1007/s00586-023-07836-9. Epub 2023 Jun 30.

DOI:10.1007/s00586-023-07836-9
PMID:37389696
Abstract

PURPOSE

Full-endoscopic lumbar interbody fusion (FELIF) is a new-generation treatment for spondylolisthesis. However, owing to their unique characteristics, the two main endoscopic fusion trajectories, the trans-Kambin and posterolateral approaches, have important limitations. Herein, we aimed to introduce a new technique called Kambin Torpedo FELIF (KT-FELIF).

METHODS

The KT-FELIF technique is based on the trans-Kambin approach. It additionally completes ipsilateral total facetectomy and contralateral direct decompression. Thus, this novel technique combines the advantages of the trans-Kambin and posterolateral approaches.

RESULTS

We reported on the indications and technical steps of KT-FELIF and provided intraoperative and animated videos to clarify the procedure. Short-term follow-up based on 3-month postoperative computed tomography and plain films images taken at least 3 months after surgery showed adequate bony decompression, a large bone graft contact area, and good intervertebral trabecular bone growth without radiolucent lines between the graft, cage, and end plate. The clinical results, such as ipsilateral and contralateral visual analog scale and Oswestry disability index values, gradually improved at 1 and 3 months postoperatively. No complications were observed.

CONCLUSIONS

KT-FELIF is a promising FELIF technique for achieving bilateral direct decompression through a unilateral approach while accomplishing thorough discectomy and endplate preparation.

摘要

目的

全内镜下腰椎体间融合术(FELIF)是治疗脊椎滑脱症的新一代治疗方法。然而,由于其独特的特点,两种主要的内镜融合轨迹,经 Kambin 和后外侧入路,具有重要的局限性。在此,我们旨在介绍一种称为 Kambin 鱼雷 FELIF(KT-FELIF)的新技术。

方法

KT-FELIF 技术基于经 Kambin 入路。它还完成同侧全关节突切除和对侧直接减压。因此,这项新技术结合了经 Kambin 和后外侧入路的优点。

结果

我们报告了 KT-FELIF 的适应证和技术步骤,并提供了术中及动画视频以阐明该手术过程。术后至少 3 个月拍摄的术后 3 个月 CT 和普通 X 线片显示,短期随访显示出充分的骨减压、大的骨移植物接触面积和良好的椎间小梁骨生长,移植物、笼和终板之间没有透亮线。术后 1 个月和 3 个月,临床结果(如同侧和对侧视觉模拟评分和 Oswestry 残疾指数)逐渐改善。无并发症发生。

结论

KT-FELIF 是一种有前途的 FELIF 技术,可通过单侧入路实现双侧直接减压,同时完成彻底的椎间盘切除术和终板准备。

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