局部麻醉下经椎间孔椎间盘切除术治疗胸椎间盘突出症:一个病例系列

Jian Shen
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引用次数: 3

摘要

背景:症状性胸椎间盘突出症是一种相对罕见但治疗难度较大的疾病。微创入路并发症少,恢复快。目的:在这里,我们描述了一种通过经椎间孔/胸膜后入路,在直接可见的情况下使用高速钻头进行全内窥镜椎间孔成形术的逐步技术,然后在局部麻醉下进行椎间盘切除术来治疗胸椎间盘突出症,并报告了一个病例系列的主要结果。结果:2012年1月至2017年12月,16例有症状的胸椎间盘突出症患者在局麻下行内镜下经椎间孔成形术和椎间盘切除术。分析并报告术中资料及临床结果。1例慢性钙化巨大中央椎间盘突出伴明显脊髓病的患者术后症状加重;随后,她在其他地方接受了开放的多层椎板切除术融合手术。其余15例患者,在最后随访时(平均:21个月;范围:7-60个月),平均VAS从7.9提高到2.1。术中及术后未见其他并发症。结论:本病例系列的结果表明,局部麻醉下全内镜下经椎间孔/胸膜后椎间孔成形术和椎间盘切除术是一种安全有效的治疗症状性软性和钙化性胸椎间盘突出症的方法。*通讯作者:沈健,莫霍克谷骨科脊柱外科,美国纽约东77街215号,脊柱再生外科中心,电话:+ 518842-2663,E-mail: james2173@yahoo.com2018年9月3日录用;引用本文:沈杰(2018)局麻下经椎间孔椎间盘切除术治疗胸椎间盘突出症:一个病例系列。[J] .中华医学杂志[J] . 37(5): 531 - 531。2165 - 7939 . doi: 10.0132 /。S7-013版权所有:©2018沈杰。这是一篇基于知识共享署名许可的开放获取文章,在注明原作者和来源的前提下,允许在任何媒体上不受限制地使用、分发和复制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Fully Endoscopic Transforaminal Discectomy under Local Anesthesia for Thoracic Disc Herniations: A Case Series
Background: Symptomatic thoracic disc herniation is a relatively rare yet challenging-to-treat condition. Minimally invasive approaches potentially offer less complications and quick recovery. Purpose: Here we describe a step-by-step technique for fully-endoscopic foraminoplasty with high-speed drill under direct visualization through transforaminal/retropleural approach, followed by discectomy to treat thoracic disc herniations under local anesthesia, and report the primary results of a case series. Results: Between January 2012 and December, 2017, 16 patients with symptomatic thoracic disc herniation were treated with fully endoscopic transforaminal foraminoplasty and discectomy under local anesthesia. Intraoperative data and clinical outcomes were analyzed and reported. One patient with a chronic calcified giant central disc herniation and significant myelopathy had complaints of worsening symptoms postoperatively; she subsequently underwent open multi-level laminectomy fusion surgery elsewhere. For the remaining 15 patients, at the final follow up (mean: 21 months; range: 7–60 months), the mean VAS was improved from 7.9 to 2.1. No other complications were observed or reported during and after the surgery. Conclusion: Results from this case series shows that fully-endoscopic transforaminal/retropleural foraminoplasty and discectomy under local anesthesia is a safe and effective treatment for symptomatic soft and calcified thoracic disc herniations. *Corresponding author: Jian Shen, Department of Spine Surgery, Mohawk Valley Orthopedics, Center for Spine Regeneration Surgery, 215 East 77th Street, New York-10075, USA, Tel: + 518842-2663, E-mail: james2173@yahoo.com Received August 24, 2018; Accepted September 03, 2018; Published September 06, 2018 Citation: Shen J (2018) Fully Endoscopic Transforaminal Discectomy under Local Anesthesia for Thoracic Disc Herniations: A Case Series. J Spine S7: 013. doi: 10.0132/2165-7939.S7-013 Copyright: © 2018 Shen J. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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