Krogman Helena, Stevens Bryan, Kanhai Meena, Meroney Matthew, Kumar Sanjeev, Jafari Amir
Department of Anesthesiology, College of Medicine, University of Florida, Gainesville, USA.
Department of Pain Management, College of Medicine, University of Florida, Gainesville, USA.
Cureus. 2024 Nov 5;16(11):e73083. doi: 10.7759/cureus.73083. eCollection 2024 Nov.
The shift toward minimally invasive procedures in American healthcare has transformed spine surgery, particularly with the rise of endoscopic techniques. Endoscopic spine surgery enables the treatment of conditions like lumbar spinal stenosis, offering advantages such as reduced tissue trauma, smaller incisions, and quicker recovery compared to traditional open surgery. Spinal stenosis, where the spinal canal narrows and compresses nerves, often results in significant pain, numbness, or weakness in the lower extremities. Despite the benefits of endoscopic decompression, it brings unique challenges, particularly regarding intraoperative bleeding control. Hemostatic agents, such as Floseal (Baxter, Deerfield, IL), a gelatin matrix, are commonly used to manage bleeding during surgery. However, their use in endoscopic procedures within confined spaces introduces considerations not seen in open surgeries. This case report presents a patient with lumbar stenosis who underwent endoscopic decompression and developed postoperative neurogenic claudication, illustrating both the outcome and the use of Floseal in minimally invasive spine surgeries.
美国医疗保健领域向微创手术的转变改变了脊柱外科手术,尤其是随着内镜技术的兴起。内镜脊柱手术能够治疗诸如腰椎管狭窄等病症,与传统的开放手术相比,具有减少组织创伤、切口更小以及恢复更快等优势。椎管狭窄是指椎管变窄并压迫神经,常导致下肢严重疼痛、麻木或无力。尽管内镜减压有诸多益处,但它也带来了独特的挑战,尤其是在术中出血控制方面。止血剂,如明胶基质的弗洛塞尔(Baxter公司,伊利诺伊州迪尔菲尔德),常用于手术期间控制出血。然而,在有限空间内的内镜手术中使用这些止血剂会带来一些开放手术中未见的考量因素。本病例报告介绍了一名接受内镜减压治疗腰椎管狭窄的患者,该患者术后出现神经源性间歇性跛行,阐述了在微创脊柱手术中的治疗结果及弗洛塞尔的使用情况。