硬膜外镜治疗椎管狭窄症。描述手术过程和减少并发症的安全措施。

IF 1.5 Q4 CLINICAL NEUROLOGY
Eva M Monzón, Alberto Rios, Javier Carrascoso, Pedro Moreno, David Abejón
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引用次数: 0

摘要

目的:本观察性研究的目的是描述使用硬膜外镜来减少椎管狭窄患者黄韧带(LF)的扩大,以及选择合适的患者和提高手术成功率的安全措施。材料与方法:我们介绍了患者的选择方案,确定了适当的适应症和安全措施,以使用硬膜外镜作为工具来减小LF的大小和增加空间,减少可能的并发症。结果:在纳入研究的患者中,没有出现通道困难或尾骨痛的病例,在Schizas D级(非常严重)狭窄患者中发生了1例尿失禁。在C级或以下狭窄的患者中,我们没有发现任何括约肌失禁的病例。在4名患者中,我们发现了感觉异常,其中1名患者出现了短暂的疼痛增加。3例患者行硬脑膜穿刺,无一例出现头痛。结论:根据磁共振成像(MRI)标准排除非常严重的椎管狭窄患者,使用骶管裂孔测量和神经生理监测有助于减少椎管狭窄患者硬膜外镜下神经系统并发症的发生。临床试验注册:https://www.clinicaltrials.gov标识符:NCT03863067。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Epiduroscopy in spinal stenosis. Description of the procedure and safety measures to reduce complications.

Aims: The aim of this observational study is to describe the use of epiduroscopy to decrease the enlargement of the ligamentum flavum (LF) in patients with spinal stenosis, as well as the selection of the appropriate patient and the safety measures that enhance procedural success.

Materials & methods: We introduce the patient selection protocol, define the appropriate indication and the safety measures to use the epiduroscopy as a tool to decrease the size of the LF and increase space, reducing possible complications.

Results: Among patients included in the study, there were no cases of access difficulty or coccydynia, and one case of urinary incontinence occurred in a patient with Schizas grade D (very severe) stenosis. In patients with grade C or lower stenosis, we have not found any case of sphincter incontinence.In four patients, we found paresthesias and in one patient a transient increase in pain. Dural puncture was performed in three patients, none developed headache.

Conclusions: Exclusion of patients with very severe canal stenosis according to magnetic resonance imaging (MRI) criteria, the use of sacral hiatus measurements and the neurophysiological monitoring helps diminish the occurrence of neurological complications of epiduroscopy in patients with spinal stenosis.

Clinical trial registration: https://www.clinicaltrials.gov identifier is NCT03863067.

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来源期刊
Pain management
Pain management CLINICAL NEUROLOGY-
CiteScore
2.90
自引率
5.90%
发文量
62
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