Transtubular Endoscopic Neuronavigation-Assisted Approach for Extraforaminal Lumbar Disk Herniations: A New Trend for a Common Neurosurgical Disease.

Q2 Medicine

Acta neurochirurgica. Supplement Pub Date : 2023-01-01 DOI:10.1007/978-3-031-36084-8_63

Nunzio Platania, Federica Paolini, Giuseppina Orlando, Dario Romano, Rosario Maugeri, Domenico Gerardo Iacopino

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引用次数: 0

Abstract

Background: Extraforaminal lumbar disk herniations (ELDHs) are relatively rare and are, till today, diagnostic and therapeutic challenges. The transmuscular paramedian approach to the extraforaminal space is today the standard surgical approach. Nevertheless, controlling the correct trajectory to the extruded disk fragment continues to represent a challenge. The application of spinal navigation and spinal endoscopy seems to offer great advantages to ELDH treatment.

Objective: The purpose of this study is to demonstrate the advantages of spinal navigation for ELDHs by taking a purely endoscopic transtubular approach, focusing on technical aspects and clinical outcomes.

Methods: Nine consecutive patients who underwent a navigation-assisted, muscle-splitting, transtubular, purely endoscopic approach for ELDHs were retrospectively analyzed. Their clinical records were reviewed. Pain evaluations and neurological assessments were conducted.

Results: We recorded a notable visual analog scale (VAS) score improvement in postoperative examinations. The mean operation time was 47.05 min. All patients were discharged on postoperative day 1.

Conclusion: The use of spinal navigation offers a great advantage to ELDH treatment. The aid of navigation allows for a patient-tailored approach and adequate surgical exploration even in face of complex lesion anatomies. The endoscopic transtubular navigated approach seems to offer a significant reduction in operative time, at least in the selected cases.

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经管腔内窥镜神经导航辅助方法治疗腰椎间盘突出症：常见神经外科疾病的新趋势。

背景：腰椎间盘突出症（ELDH）相对罕见，至今仍是诊断和治疗方面的难题。目前，经肌旁路进入椎间盘孔外间隙是标准的手术方法。然而，控制挤压椎间盘碎片的正确轨迹仍然是一项挑战。脊柱导航和脊柱内窥镜的应用似乎为 ELDH 治疗提供了巨大优势：本研究的目的是通过纯粹的内窥镜经管状方法，展示脊柱导航治疗ELDH的优势，重点关注技术方面和临床结果：回顾性分析了九名连续接受导航辅助、肌肉分割、经耻骨联合、纯内窥镜方法治疗 ELDHs 的患者。回顾了他们的临床记录。结果：术后检查结果显示，视觉模拟量表（VAS）评分明显改善。平均手术时间为 47.05 分钟。所有患者均于术后第 1 天出院：结论：脊柱导航的使用为 ELDH 治疗带来了巨大优势。即使面对复杂的病变解剖结构，导航的辅助也能为患者提供量身定制的方法和充分的手术探查。至少在选定的病例中，内窥镜经管状导航方法似乎能显著缩短手术时间。

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来源期刊

Acta neurochirurgica. Supplement Medicine-Surgery

CiteScore

1.90

自引率

0.00%

发文量

期刊介绍： In addition to the regular journal, "Acta Neurochirurgica" publishes 3-4 supplement volumes per year. These comprise proceedings of international meetings or other material of general neurosurgical interest.