Foramioplasts

A. Kavi
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引用次数: 0

摘要

在过去的10年里,经椎间孔内窥镜腰椎手术取得了突飞猛进的发展,因此,它现在不局限于简单的椎间盘突出症。现在,它可以成功地用于中心疝、椎间孔外疝、挤压疝和移位疝,当手术仅限于中心椎间盘内核切开术或去核时,这些都被认为是不良的适应症。随着对椎间孔解剖结构的更好理解,现在正在进行更大胆的椎间孔手术。此外,随着器械的进一步发展,如电动毛刺和激光,我们现在可以成功治疗椎间孔和侧管狭窄。凭借经孔内窥镜技术的优势,如使用局部麻醉、最小的皮肤切口、无需神经肌肉收缩和无需过度骨切除,且与入路相关的发病率最低,使其能够在极端年龄段安全应用,尽早恢复正常生活。在经孔内窥镜手术中,椎间孔成形术对于实现这些扩展目标至关重要。椎间孔成形术一词在脊椎内窥镜医生中被广泛用于描述椎间孔边界的扩张,并且它被可逆地用于描述椎间孔切开术。然而,进行椎间孔切开术是为了扩大椎间孔,达到遥远而困难的目标,而进行椎间孔成形术是为了减压神经结构,以治疗椎间孔和侧部狭窄。在本文中,我们将讨论这两种程序。为了理解其原理并成功地应用该技术,让我们首先了解椎间孔解剖。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Foraminoplasty
Transforaminal endoscopic lumbar spine surgery has evolved leaps and bounds in the last 10 years, and as such, it is now not limited to simple contained herniation. It can now be successfully done for central, extraforaminal, extruded, and migrated herniations, which were considered bad indications when the procedure was limited to central intradiscal nucleotomy or debulking. With better understanding of the foraminal anatomy, more bold approaches to intervertebral foramen are now being undertaken. Moreover, with further development in instruments, such as motorized burrs and lasers, we can now successfully treat the foraminal and lateral canal stenosis. With the advantages of Transforaminal endoscopic techniques, such as use of local anesthesia, minimal skin incision, no need for neuromuscular retraction, and no excessive bone removal, with minimal approach-related morbidity, allows it to be applied safely in extremes of age, with early return to normal life. The procedure of foraminoplasty is vital to achieve these extended targets in Transforaminal endoscopic surgeries. The term foraminoplasty is used among the spine endoscopists to broadly describe the expansion of the foraminal boundaries and it is reversibly used to describe foraminotomy. However, foraminotomy is performed for widening the foramen to reach far off and difficult targets, whereas foraminoplasty is performed for decompression of neural structures in the treatment of foraminal and lateral stenosis. In this article, we discuss both the procedures. To understand the principles and successfully employ the technique, let us first understand the foraminal anatomy.
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