Li Yongneng, Qian Fei, Sun Fei, Song En
Spine Surgery, The Second People's Hospital of Qujing, Yunnan, China.
Orthopedics and Traumatology Department, Luliang County Traditional Chinese Medicine Hospital, Yunnan, China.
J Orthop. 2024 Jul 5;58:90-95. doi: 10.1016/j.jor.2024.07.003. eCollection 2024 Dec.
Lumbar spinal epidural lipomatosis (SEL) is a rare condition characterized by the pathological proliferation of adipose tissue in the epidural space of the spinal canal. This study presents the case of a 59-year-old male with lumbar SEL treated effectively in the short term through arthroscopic-assisted uniportal spinal surgery (AUSS) combined with a modified circle-drawing unilateral laminotomy with bilateral decompression (ULBD) technique.
A modified circle-drawing ULBD procedure was executed via AUSS for a patient with SEL. The procedure involved the excision of diseased adipose tissue from the spinal canal, enlargement and decompression of the spinal canal, liberation of nerves, and post-operative evaluation of imaging results and clinical outcomes.
The patient exhibited improvements in the dural sac cross-sectional area, low back pain Visual Analogue Score (VAS, leg pain VAS, lumbar spine Japanese Orthopaedic Association (JOA), and EQ-5D post-surgery.
AUSS offers comprehensive visualization, straightforward positioning, facilitating a broad field of view and precise lesion management. The modified circle-drawing ULBD technique characterized by its simplicity, operational freedom, and extensive decompression range, contributes to symptom alleviation and patient recovery.
腰椎硬脊膜外脂肪增多症(SEL)是一种罕见病症,其特征为椎管硬膜外间隙脂肪组织的病理性增生。本研究介绍了一例59岁男性腰椎SEL患者,通过关节镜辅助单通道脊柱手术(AUSS)联合改良画圈单侧椎板切开双侧减压(ULBD)技术在短期内得到有效治疗的病例。
通过AUSS对一名SEL患者实施改良画圈ULBD手术。该手术包括从椎管切除病变脂肪组织、扩大椎管并减压、松解神经以及术后对影像学结果和临床结局进行评估。
患者术后硬脊膜囊横截面积、腰背痛视觉模拟评分(VAS)、腿痛VAS、腰椎日本骨科协会(JOA)评分以及EQ-5D均有改善。
AUSS提供全面的可视化、定位直接,便于获得广阔视野和精确处理病变。改良画圈ULBD技术具有操作简单、操作自由度大、减压范围广的特点,有助于缓解症状和患者康复。