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颈椎中央及经椎弓根全内镜减压手术技术:技术说明

Surgical Technique of Central and Over-the-Top Full-Endoscopic Decompression of the Cervical Spine: A Technical Note.

作者信息

Bergamaschi João Paulo Machado, Brito Marcelo Botelho Soares de, Araújo Fernando Flores de, Graciano Ricardo Squiapati, Utino Edgar Takao, Lewandrowski Kai-Uwe, Wirth Fernanda

机构信息

Atualli Spine Care Clinic, 745 Alameda Santos, Cj. 71, São Paulo 01419-001, Brazil.

Atualli Academy, 2504 Brigadeiro Luís Antônio, Cj. 172, São Paulo 01402-000, Brazil.

出版信息

J Pers Med. 2023 Oct 18;13(10):1508. doi: 10.3390/jpm13101508.

Abstract

Endoscopic surgery of the cervical spine is constantly evolving and the spectrum of its indications has expanded in recent decades. Full-endoscopic techniques have standardized the procedures for posterior and anterior access. The full-endoscopic approach was developed to treat degenerative diseases with the least possible invasion and without causing instability of the cervical spine. The posterior full-endoscopic approach is indicated for the treatment of diseases of the lateral part of the vertebral segment, such as herniations and stenoses of the lateral recess and vertebral foramen. There has been little discussion of this approach to the treatment of central stenosis of the cervical spine. This technical note describes a step-by-step surgical technique for central and over-the-top full-endoscopic decompression in the cervical spine, using a 3.7 mm working channel endoscope. This technique has already been shown to be effective in a recent case series with a 4.7 mm working channel endoscope, and may represent a new treatment option for central or bilateral lateral recess stenosis. There is also the possibility of a bilateral full-endoscopic approach, but this may be associated with greater muscle damage and a longer operative time. Case series and comparative studies should be encouraged to confirm the safety and utility of this technique.

摘要

颈椎内镜手术不断发展,近几十年来其适应证范围不断扩大。全内镜技术已使后路和前路手术标准化。全内镜手术方法旨在以尽可能小的侵袭性治疗退行性疾病,且不导致颈椎失稳。后路全内镜手术适用于治疗椎体节段外侧部分的疾病,如侧隐窝和椎间孔的突出及狭窄。对于颈椎中央管狭窄的这种治疗方法,讨论较少。本技术说明介绍了一种使用3.7毫米工作通道内镜进行颈椎中央管及经顶全内镜减压的分步手术技术。最近的一个病例系列已表明该技术使用4.7毫米工作通道内镜有效,可能代表中央或双侧侧隐窝狭窄的一种新治疗选择。也有双侧全内镜手术的可能性,但这可能会导致更大的肌肉损伤和更长的手术时间。应鼓励进行病例系列和对比研究以证实该技术的安全性和实用性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4829/10608411/51a852265de6/jpm-13-01508-g001.jpg

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