PDF(Pubmed)
Abstract：
UNASSIGNED: With a dramatic increase in elderly population worldwide, the prevalence of degenerative spine disease is steadily rising. Even though the entire spinal column is affected the problem is more commonly seen in the lumbar, cervical spine and to some extent the thoracic spine. The treatment of symptomatic lumbar disc or stenosis is primarily conservative with analgesics, epidural steroids and physiotherapy. Surgery is advised only if conservative treatment is ineffective. Conventional open microscopic procedures even though are still a gold standard, have the disadvantages of excessive muscle damage and bone resection, epidural scarring along with prolonged hospital stay and increased need of postoperative analgesics. Minimal access spine surgeries minimize surgical access related injury by minimizing soft tissue and muscle damage and also bony resection thus preventing iatrogenic instability and unnecessary fusions. This leads to good functional preservation of the spine and enhances early postoperative recovery and early return to work. Full endoscopic spine surgeries are one of the more sophisticated and advanced form of MIS surgeries.
UNASSIGNED: Full endoscopy has definitive benefits over conventional microsurgical techniques. These include better and clear vision of the pathology due to presence of irrigation fluid channel, minimal soft tissue and bone trauma, better and relatively easy approach to deep seated pathologies like thoracic disc herniations and a possibility to avoid fusion surgeries. The purpose of this article is to describe these benefits, give an overview of the two main approaches - transforaminal and interlaminar, their indications, contraindications and their limitations. The article also describes about the challenges in overcoming the learning curve and its future prospectives.
UNASSIGNED: Full endoscopic spine surgery is one of the fastest growing technique in the field of modern spine surgery. Better intraoperative visualization of the pathology, lesser incidence of complications, faster recovery time, less postoperative pain, better relief of symptoms and early return to activity are the main reasons behind this rapid growth. With better patient outcomes and reduced medical costs, the procedure is going to be more accepted, relevant and popular procedure in future.
UNASSIGNED: Full endoscopy has definitive benefits over conventional microsurgical techniques. These include better and clear vision of the pathology due to presence of irrigation fluid channel, minimal soft tissue and bone trauma, better and relatively easy approach to deep seated pathologies like thoracic disc herniations and a possibility to avoid fusion surgeries. The purpose of this article is to describe these benefits, give an overview of the two main approaches - transforaminal and interlaminar, their indications, contraindications and their limitations. The article also describes about the challenges in overcoming the learning curve and its future prospectives.
UNASSIGNED: Full endoscopic spine surgery is one of the fastest growing technique in the field of modern spine surgery. Better intraoperative visualization of the pathology, lesser incidence of complications, faster recovery time, less postoperative pain, better relief of symptoms and early return to activity are the main reasons behind this rapid growth. With better patient outcomes and reduced medical costs, the procedure is going to be more accepted, relevant and popular procedure in future.
摘要：
■随着全球老年人口的急剧增加，退行性脊柱疾病的患病率正在稳步上升。即使整个脊柱受到影响，这个问题也更常见于腰椎，颈椎和一定程度的胸椎。有症状的腰椎间盘或狭窄症的治疗主要是用镇痛药保守治疗，硬膜外类固醇和物理治疗。只有在保守治疗无效时才建议手术。传统的开放显微镜程序尽管仍然是黄金标准，有过度肌肉损伤和骨切除的缺点，硬膜外瘢痕，住院时间延长，术后镇痛药的需求增加。微创脊柱手术通过最大程度地减少软组织和肌肉损伤以及骨切除术来最大程度地减少与手术相关的损伤，从而防止医源性不稳定和不必要的融合。这导致脊柱的良好功能保留，并增强术后早期恢复和早期恢复工作。全内窥镜脊柱手术是MIS手术的更复杂和高级形式之一。
■与传统的显微外科技术相比，全内窥镜检查具有明确的优势。这些包括由于存在冲洗液通道而对病理有更好和清晰的视野，轻微的软组织和骨创伤，更好，相对容易的方法来治疗深部病变，如胸椎间盘突出症，并有可能避免融合手术。本文的目的是描述这些好处，概述了两种主要的方法-经椎间孔和层间，他们的适应症，禁忌症及其局限性。本文还介绍了克服学习曲线的挑战及其未来前景。
■全内窥镜脊柱手术是现代脊柱外科领域发展最快的技术之一。更好的术中病理学可视化，并发症发生率较低，更快的恢复时间，术后疼痛减少，症状的更好缓解和早期恢复活动是这种快速增长背后的主要原因。通过更好的患者治疗效果和降低的医疗成本，该程序将被更多地接受，未来的相关和流行的程序。
■与传统的显微外科技术相比，全内窥镜检查具有明确的优势。这些包括由于存在冲洗液通道而对病理有更好和清晰的视野，轻微的软组织和骨创伤，更好，相对容易的方法来治疗深部病变，如胸椎间盘突出症，并有可能避免融合手术。本文的目的是描述这些好处，概述了两种主要的方法-经椎间孔和层间，他们的适应症，禁忌症及其局限性。本文还介绍了克服学习曲线的挑战及其未来前景。
■全内窥镜脊柱手术是现代脊柱外科领域发展最快的技术之一。更好的术中病理学可视化，并发症发生率较低，更快的恢复时间，术后疼痛减少，症状的更好缓解和早期恢复活动是这种快速增长背后的主要原因。通过更好的患者治疗效果和降低的医疗成本，该程序将被更多地接受，未来的相关和流行的程序。
