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内镜脊柱手术的叙述性综述:历史、适应症、用途及未来方向。

A narrative review of endoscopic spine surgery: history, indications, uses, and future directions.

作者信息

Antonacci Christopher L, Zeng Francine R, Ford Brian, Wellington Ian, Kia Cameron, Zhou Hanbing

机构信息

Department of Orthopaedic Surgery, University of Connecticut, Farmington, CT, USA.

Orthopedic Associates of Hartford, Bone and Joint Institute, Hartford, CT, USA.

出版信息

J Spine Surg. 2024 Jun 21;10(2):295-304. doi: 10.21037/jss-23-112. Epub 2024 May 10.

Abstract

BACKGROUND AND OBJECTIVE

The concept of endoscopic surgery began in the 1930s and has since undergone numerous advancements in both technology and surgical indications. Its main benefit is providing the opportunity to perform surgery while minimizing disruption to surrounding structures. The purpose of this review is to summarize the history, uses, and future directions for spine endoscopic surgery.

METHODS

A review of national databases was performing using key terms "endoscopic", "spine" and "surgery" for literature from 1900 to 2023. Studies that aimed to describe the utilities of endoscopic surgeries, associated outcomes, limitations, and future directions were included. Studies that were not in English were excluded.

KEY CONTENT AND FINDINGS

This review includes a brief overview of the history of endoscopic surgery and its current two main approaches, transforaminal and interlaminar approaches. It then summarizes the main indications and utilization of endoscopic surgery in the lumbar, cervical and thoracic spine, as well as expansion in managing spine tumors, infections, and outpatient surgical cases.

CONCLUSIONS

There are many rising indications and uses for endoscopic spine surgery in nearly every aspect of the spine. Compared to conventional spine surgery, there is early evidence showing endoscopic surgery is associated with less post-operative pain, shorter hospital stays, and possibly quicker recovery times. As current trends in spine surgery move towards minimally invasive techniques, it is anticipated that the use of endoscopic surgery will continue to expand.

摘要

背景与目的

内镜手术的概念始于20世纪30年代,自那时起在技术和手术适应症方面都取得了众多进展。其主要优势在于提供了在尽量减少对周围结构干扰的情况下进行手术的机会。本综述的目的是总结脊柱内镜手术的历史、用途及未来发展方向。

方法

使用关键词“内镜”“脊柱”和“手术”对1900年至2023年的文献进行国家数据库检索。纳入旨在描述内镜手术的效用、相关结果、局限性及未来发展方向的研究。排除非英文研究。

关键内容与发现

本综述简要概述了内镜手术的历史及其目前的两种主要入路,即经椎间孔入路和椎板间入路。然后总结了内镜手术在腰椎、颈椎和胸椎的主要适应症及应用情况,以及在脊柱肿瘤、感染和门诊手术病例管理方面的拓展。

结论

脊柱内镜手术在脊柱的几乎各个方面都有许多不断增加的适应症和用途。与传统脊柱手术相比,早期证据表明内镜手术术后疼痛较轻、住院时间较短且恢复时间可能更快。随着脊柱手术当前的趋势朝着微创技术发展,预计内镜手术的应用将继续扩大。

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Endoscopic treatment of spondylodiscitis: systematic review.
Eur Spine J. 2022 Jul;31(7):1765-1774. doi: 10.1007/s00586-022-07142-w. Epub 2022 Feb 24.
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Transforaminal Endoscopic Lumbar Discectomy: Basic Concepts and Technical Keys to Clinical Success.
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