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针对腰椎管狭窄症的三步法,结合解剖学见解,为年轻脊柱外科医生量身定制。

The 3-Steps Approach for Lumbar Stenosis with Anatomical Insights, Tailored for Young Spine Surgeons.

作者信息

Rocca Giuseppe La, Galieri Gianluca, Mazzucchi Edoardo, Pignotti Fabrizio, Orlando Vittorio, Pappalardo Simona, Olivi Alessandro, Sabatino Giovanni

机构信息

Institute of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University, 00168 Rome, Italy.

Neurosurgical Training Center and Brain Research, Mater Olbia Hospital, 07026 Olbia, Italy.

出版信息

J Pers Med. 2024 Sep 16;14(9):985. doi: 10.3390/jpm14090985.

Abstract

: Lumbar decompression surgery for degenerative lumbar stenosis is an intervention which addresses a degenerative condition affecting many patients. This article presents a meticulous three-phase surgical approach, derived from our clinical experiences and intertwining anatomical insights, offering a nuanced perspective tailored for the educational needs of young spinal surgeons. : Six hundred and eighty-seven patients who underwent lumbar decompression surgery at a single institution were included in the present study. A retrospective analysis of patient demographics and surgical techniques was performed. All surgeries were performed by a consistent surgical team, emphasizing uniformity in approach. The surgical technique involves a meticulous three-phase process comprising exposure and skeletal visualization; microscopic identification and decompression; and undermining of the spinous process base and contralateral decompression. Presenting results from 530 patients, the study examines demographic characteristics, health profiles, operative details, complications, and clinical assessments. The three-phase approach demonstrates low complication rates, absence of recurrences, and improved clinical outcomes, emphasizing its efficacy. : The three-phase surgical approach emerges as a valuable educational tool for both novice and seasoned spinal surgeons. Rooted in anatomical insights, the structured methodology not only caters to the educational needs of young surgeons, but also ensures a standardized and safe procedure. The emphasis on tissue preservation and anatomical points aligns with current trends toward minimally invasive techniques, promising enhanced patient outcomes and satisfaction.

摘要

腰椎管狭窄症的腰椎减压手术是一种针对影响众多患者的退行性疾病的干预措施。本文介绍了一种细致的三阶段手术方法,该方法源自我们的临床经验并融合了解剖学见解,为年轻脊柱外科医生的教育需求提供了一个细致入微的视角。

本研究纳入了在单一机构接受腰椎减压手术的687例患者。对患者人口统计学和手术技术进行了回顾性分析。所有手术均由一个固定的手术团队进行,强调手术方法的一致性。手术技术包括一个细致的三阶段过程,即暴露和骨骼可视化;显微镜下识别和减压;以及棘突基部的潜行分离和对侧减压。该研究展示了530例患者的结果,考察了人口统计学特征、健康状况、手术细节、并发症和临床评估。三阶段手术方法显示出低并发症发生率、无复发情况以及改善的临床结果,突出了其有效性。

三阶段手术方法成为新手和经验丰富的脊柱外科医生的宝贵教育工具。基于解剖学见解,这种结构化方法不仅满足年轻外科医生的教育需求,还确保了标准化和安全的手术过程。对组织保留和解剖要点的强调与当前微创技术的趋势一致,有望提高患者的治疗效果和满意度。

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