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全内镜经椎间孔胸椎椎间盘切除术手术技术。

Full Endoscopic Transforaminal Thoracic Discectomy Operative Technique.

作者信息

Barber Sean M, Huang Meng

机构信息

Department of Neurosurgery, Houston Methodist Neurological Institute;

Department of Neurosurgery, Houston Methodist Neurological Institute.

出版信息

J Vis Exp. 2024 Jan 12(203). doi: 10.3791/65951.

Abstract

Thoracic disc herniations are a degenerative pathology of the thoracic spine wherein a portion of nucleus pulposis herniates into the epidural space, potentially causing spinal cord or nerve root compression. Traditional surgical treatment for patients with thoracic disc herniations requires relatively invasive anterior or posterolateral approaches that involve extensive muscular dissection and removal of bone in order to access and remove the disc herniation without causing undue compression of the spinal cord. Full endoscopic thoracic discectomy is a minimally invasive technique which allows for the resection of thoracic disc herniations through a small (1 cm) incision, minimizing collateral tissue trauma and obviating the need for the extensive muscle dissection and bony removal required for traditional surgical approaches. In this article, we describe in detail the operative technique for full endoscopic thoracic discectomy and discuss the pearls and pitfalls of the technique. We also provide a review of the outcomes and complications as seen in the literature.

摘要

胸椎间盘突出症是一种胸段脊柱的退行性病变,其中一部分髓核疝入硬膜外间隙,可能导致脊髓或神经根受压。传统的胸椎间盘突出症患者的手术治疗需要相对侵入性的前路或后路方法,这些方法需要广泛的肌肉解剖和骨切除,以便在不引起脊髓过度压迫的情况下进入和切除椎间盘突出物。全内镜下胸椎椎间盘切除术是一种微创技术,可通过小切口(1 厘米)切除胸椎间盘突出物,最大限度地减少了对侧组织的创伤,避免了传统手术方法所需的广泛肌肉解剖和骨切除。在本文中,我们详细描述了全内镜下胸椎椎间盘切除术的手术技术,并讨论了该技术的要点和陷阱。我们还回顾了文献中所见的结果和并发症。

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