Cekov Asen, Guentchev Marin, Nakov Vladimir, Kanev Anastas, Tarev Ivan
Department of Neurosurgery, Acibadem City Clinic Tokuda Hospital, Sofia, BGR.
Cureus. 2024 Jul 30;16(7):e65737. doi: 10.7759/cureus.65737. eCollection 2024 Jul.
Lumbar spinal stenosis is a widespread condition that significantly affects the quality of life in elderly individuals. Conservative therapy has a positive effect on patients whose primary symptom is pain. However, in severe cases with the presence of hypesthesia and paresis, surgical treatment comes into consideration. The aim of surgery is to decompress the neurovascular elements compressed by the narrowed spinal canal while preserving spinal stability. Conventional laminectomy, with or without fusion, has been considered effective for the treatment of this pathology, but its drawbacks are significant, including tissue trauma, secondary instability, and a substantial percentage of reoperations due to complications. In recent years, various minimally invasive spine surgery techniques have emerged, showing comparable results to laminectomy decompression in terms of relieving symptomatic spinal stenosis. Additionally, these techniques offer significant benefits such as minimal tissue trauma, reduced complication rates, and shorter operative time and recovery periods. Given the continuous development and improvement, minimally invasive surgery is expected to widely replace traditional open surgery for the treatment of lumbar stenosis in the future. In this article, we present our experience in the surgical treatment of patients with degenerative lumbar stenosis, detailing the technique of the minimally invasive procedure we utilize and highlighting some of the clinical cases in which it has been applied.
腰椎管狭窄症是一种广泛存在的疾病,严重影响老年人的生活质量。保守治疗对以疼痛为主要症状的患者有积极作用。然而,在出现感觉减退和轻瘫的严重病例中,则考虑手术治疗。手术的目的是解除被狭窄椎管压迫的神经血管结构,同时保持脊柱稳定性。传统的椎板切除术,无论是否进行融合,都被认为对治疗这种病症有效,但其缺点也很明显,包括组织创伤、继发性不稳定以及因并发症导致的相当比例的再次手术。近年来,各种微创脊柱手术技术不断涌现,在缓解症状性腰椎管狭窄方面显示出与椎板切除减压术相当的效果。此外,这些技术还具有显著优势,如组织创伤最小、并发症发生率降低、手术时间和恢复时间缩短。鉴于其不断发展和改进,预计未来微创手术将广泛取代传统开放手术治疗腰椎管狭窄症。在本文中,我们介绍了我们在退行性腰椎管狭窄症患者手术治疗方面的经验,详细阐述了我们所采用的微创手术技术,并重点介绍了一些应用该技术的临床病例。