Risk Analysis of Neurological Deterioration Associated With Fluid Insufflation in Uniportal Spine Endoscopy: A Case Series and Literature Review.

IF 1.7 Q2 SURGERY

International Journal of Spine Surgery Pub Date : 2025-03-12 DOI:10.14444/8730

Daniel Liu, Ralph Jasper Mobbs

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引用次数: 0

Abstract

Background: Uniportal spine endoscopy is a minimally invasive technique gaining widespread popularity, but fluid insufflation during the procedure poses risks of neurological deterioration. The present study examines these risks through a case series and literature review.

Methods: A review of the literature was conducted to identify reported complications related to fluid insufflation. Additionally, we present a case series of 3 patients who experienced neurological deterioration associated with irrigation pressures.

Results: Key findings from the literature include complications such as raised intracranial pressure, seizures, durotomy-induced injuries, and unintended fluid migration. This case series describes novel complications, including transient ipsilateral weakness and lumbosacral plexopathy, linked to high irrigation pressures.

Conclusion: Neurological deterioration, though rare, is a significant risk in uniportal spine endoscopy. Future research should focus on defining optimal irrigation parameters and pressure management strategies.Clinical RelevanceBy understanding the mechanisms in which fluid insufflation may cause neurological deterioration and by consequently adopting preventive strategies, surgeons can reduce complications and improve patient outcomes.

Level of evidence: 4:

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单门静脉脊柱内窥镜检查中与液体充血相关的神经功能恶化的风险分析：一个病例系列和文献回顾。

背景：单门脊柱内窥镜检查是一种微创技术，得到了广泛的普及，但在手术过程中液体注入有神经系统恶化的风险。本研究通过案例系列和文献综述来检验这些风险。方法：回顾文献，确定已报道的与液体充气相关的并发症。此外，我们提出了3例患者的病例系列，他们经历了与冲洗压力相关的神经退化。结果：文献中的主要发现包括并发症，如颅内压升高、癫痫发作、硬膜切开术引起的损伤和意外的液体迁移。本病例系列描述了新的并发症，包括一过性同侧虚弱和腰骶神经丛病，与高冲洗压力有关。结论：神经功能恶化，虽然罕见，但在单门脊柱内窥镜检查中是一个重要的风险。未来的研究应侧重于确定最佳灌溉参数和压力管理策略。通过了解液体注入可能导致神经功能恶化的机制并采取相应的预防策略，外科医生可以减少并发症并改善患者的预后。证据等级：4；

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来源期刊

International Journal of Spine Surgery Medicine-Surgery

CiteScore

3.10

自引率

0.00%

发文量

162

期刊介绍： The International Journal of Spine Surgery is the official scientific journal of ISASS, the International Intradiscal Therapy Society, the Pittsburgh Spine Summit, and the Büttner-Janz Spinefoundation, and is an official partner of the Southern Neurosurgical Society. The goal of the International Journal of Spine Surgery is to promote and disseminate online the most up-to-date scientific and clinical research into innovations in motion preservation and new spinal surgery technology, including basic science, biologics, and tissue engineering. The Journal is dedicated to educating spine surgeons worldwide by reporting on the scientific basis, indications, surgical techniques, complications, outcomes, and follow-up data for promising spinal procedures.