Suvithayasiri Siravich, Kim Young-Jin, Liu Yanting, Lee Changik, Vasant Khandge Ashwinkumar, Kim Jin-Sung
Department of Neurosurgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Orthopedics, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand.
J Neurosurg Case Lessons. 2024 Aug 19;8(8). doi: 10.3171/CASE23512.
In recent developments, full endoscopic and unilateral biportal endoscopic (UBE) spine surgery have emerged to aid the transforaminal lumbar interbody fusion (TLIF) procedure. Yet, both approaches present a challenge due to limited space for cage insertion, potentially leading to complications such as cage subsidence or nonfusion in long-term assessments. Utilizing double cages may mitigate these concerns. This paper presents a unique case in which a patient successfully underwent computed tomography (CT) navigation-guided UBE-TLIF with 2 converging cages, highlighting the potential benefits and feasibility of this innovative approach.
A 59-year-old female diagnosed with degenerative spondylolisthesis at the L4-5 level underwent a UBE-TLIF. The operation is detailed step by step and supported by illustrative figures and surgical videos. Postsurgery results revealed a significant improvement in the patient's condition, with the visual analog scale score decreasing from 7 to 3 on the first day, leading to a satisfaction rate of 90% at the last follow-up.
Utilizing endoscopic visualization complemented by contrast medium has substantially elevated the quality of disc preparation. From their observations, the authors affirm that the integration of intraoperative CT navigation systems significantly augments safety and pinpoint accuracy in UBE-TLIF procedures. The strategy of employing 2 converging cages through a unilateral technique stands as a practical solution, potentially optimizing the fusion outcomes of UBE-TLIF surgery. https://thejns.org/doi/10.3171/CASE23512.
在最近的发展中，全内镜和单侧双通道内镜（UBE）脊柱手术已出现，以辅助经椎间孔腰椎椎间融合术（TLIF）。然而，由于椎间融合器植入空间有限，这两种方法都面临挑战，在长期评估中可能导致诸如椎间融合器下沉或不融合等并发症。使用双椎间融合器可能会减轻这些担忧。本文介绍了一个独特的病例，一名患者成功接受了计算机断层扫描（CT）导航引导下的双侧汇聚椎间融合器UBE-TLIF手术，突出了这种创新方法的潜在益处和可行性。
一名59岁女性被诊断为L4-5节段退行性腰椎滑脱，接受了UBE-TLIF手术。手术步骤详细，并配有说明性图片和手术视频。术后结果显示患者病情有显著改善，视觉模拟评分从第一天的7分降至3分，在最后一次随访时满意度达到90%。
利用内镜可视化并辅以造影剂，显著提高了椎间盘准备的质量。根据他们的观察，作者确认术中CT导航系统的整合显著提高了UBE-TLIF手术的安全性和精确性。通过单侧技术使用两个汇聚椎间融合器的策略是一种切实可行的解决方案，可能会优化UBE-TLIF手术的融合效果。https://thejns.org/doi/10.3171/CASE23512 。
