一种使用单侧双孔道内镜经椎间孔入路治疗椎管内腰椎间盘突出症的新手术方法:病例系列
A new surgical method to treat intracanal lumbar disc herniation using the unilateral biportal endoscopic transforaminal approach: patient series.
作者信息
Segawa Tomohide, Iwai Hiroki, Inanami Hirohiko, Takano Yuichi, Yuzawa Yohei, Kaneko Takeshi, Taniguchi Kenta, Yanagisawa Kazuyoshi, Yokosuka Junichi, Tominaga Ryoji, Nakamoto Hideki, Sasaki Katsuyuki, Koga Hisashi
机构信息
1Department of Orthopaedic Surgery, Inanami Spine and Joint Hospital, Tokyo, Japan.
2Department of Orthopaedics, Iwai Orthopaedic Medical Hospital, Tokyo, Japan.
出版信息
J Neurosurg Case Lessons. 2024 Jan 29;7(5). doi: 10.3171/CASE23608.
BACKGROUND
Unilateral biportal endoscopic lumbar discectomy (UBELD) is a new minimally invasive spine surgery. The purpose of this study is to describe a new surgical method to treat intracanal lumbar disc herniation (LDH) using the unilateral biportal endoscopic transforaminal approach (UBE-TFA). The first 15 patients who had undergone UBELD for single-level LDH were included in this study. Operative time, intraoperative blood loss, postoperative stay, and intraoperative complications were recorded. The Oswestry Disability Index (ODI), numeric rating scale (NRS) score for leg pain, and modified MacNab criteria were assessed at 3 months postoperatively.
OBSERVATIONS
The mean operative time was 52.0 ± 13.8 minutes. The mean intraoperative blood loss was 10.5 ± 10.2 mL. The mean postoperative stay was 1.1 ± 0.3 days. There were no complications. The postoperative mean ODI was significantly improved from 44.9 ± 14.4 to 7.7 ± 11.2 at the final follow-up (p < 0.001). There was a significant decrease in the postoperative mean NRS score for leg pain, from 6.1 ± 1.9 to 0.8 ± 1.3 at the final follow-up (p < 0.001). Based on the modified MacNab criteria, good to excellent results were obtained in 86.7% of the patients.
LESSONS
We considered UBELD-TFA as not only one of the promising surgical methods for UBELD, but also a new surgical implementation of the TFA.
背景
单侧双通道内镜下腰椎间盘切除术(UBELD)是一种新型的微创脊柱手术。本研究的目的是描述一种使用单侧双通道内镜经椎间孔入路(UBE-TFA)治疗椎管内腰椎间盘突出症(LDH)的新手术方法。本研究纳入了首批15例接受UBELD治疗单节段LDH的患者。记录手术时间、术中出血量、术后住院时间和术中并发症。在术后3个月评估奥斯威斯利功能障碍指数(ODI)、腿痛数字评定量表(NRS)评分和改良MacNab标准。
观察结果
平均手术时间为52.0±13.8分钟。平均术中出血量为10.5±10.2毫升。平均术后住院时间为1.1±0.3天。无并发症发生。末次随访时,术后平均ODI从44.9±14.4显著改善至7.7±11.2(p<0.001)。术后平均腿痛NRS评分从6.1±1.9显著降至末次随访时的0.8±1.3(p<0.001)。根据改良MacNab标准,86.7%的患者获得了良好至优秀的结果。
经验教训
我们认为UBE-TFA不仅是UBELD有前景的手术方法之一,也是TFA的一种新的手术应用。
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