PDF(Pubmed)
Abstract：
OBJECTIVE: To investigate the effect of a three-dimensional (3D) exoscope for decompression of single-segment massive lumbar disc herniation (LDH).
METHODS: The study included 56 consecutive patients with single segment massive LDH who underwent decompression assisted by a 3D exoscope from October 2019 to October 2022 at a university hospital. The analysis was based on comparison of perioperative metrics including decompression time, estimated blood loss (EBL) during decompression and postoperative length of stay (PLS); clinical outcomes including assessment using the visual analogue scale (VAS) and the Oswestry disability index (ODI); and incidence of reoperation and complications.
RESULTS: The mean decompression time was 28.35 ± 8.93 min (lumbar interbody fusion (LIF)) and 15.50 ± 5.84 min (fenestration discectomy (LOVE surgery)), the mean EBL during decompression was 42.65 ± 12.42 ml (LIF) and 24.32 ± 8.61 ml (LOVE surgery), and the mean PLS was 4.56 ± 0.82 days (LIF) and 2.00 ± 0.65 days (LOVE surgery). There were no complications such as cerebrospinal fluid leakage, nerve root injury and epidural hematoma. All patients who underwent decompression assisted by a 3D exoscope were followed up for 6 months. At the last follow-up, the VAS and ODI scores were significantly improved from the preoperative period to the last follow-up (P < 0.05).
CONCLUSIONS: A 3D exoscope provides a visually detailed, deep and clear surgical field, which makes decompression safer and more effective and reduces short-term complications. A 3D exoscope may be a good assistance tool during decompression for single-segment massive LDH.
METHODS: The study included 56 consecutive patients with single segment massive LDH who underwent decompression assisted by a 3D exoscope from October 2019 to October 2022 at a university hospital. The analysis was based on comparison of perioperative metrics including decompression time, estimated blood loss (EBL) during decompression and postoperative length of stay (PLS); clinical outcomes including assessment using the visual analogue scale (VAS) and the Oswestry disability index (ODI); and incidence of reoperation and complications.
RESULTS: The mean decompression time was 28.35 ± 8.93 min (lumbar interbody fusion (LIF)) and 15.50 ± 5.84 min (fenestration discectomy (LOVE surgery)), the mean EBL during decompression was 42.65 ± 12.42 ml (LIF) and 24.32 ± 8.61 ml (LOVE surgery), and the mean PLS was 4.56 ± 0.82 days (LIF) and 2.00 ± 0.65 days (LOVE surgery). There were no complications such as cerebrospinal fluid leakage, nerve root injury and epidural hematoma. All patients who underwent decompression assisted by a 3D exoscope were followed up for 6 months. At the last follow-up, the VAS and ODI scores were significantly improved from the preoperative period to the last follow-up (P < 0.05).
CONCLUSIONS: A 3D exoscope provides a visually detailed, deep and clear surgical field, which makes decompression safer and more effective and reduces short-term complications. A 3D exoscope may be a good assistance tool during decompression for single-segment massive LDH.
摘要：
目的：探讨三维（3D）镜在单节段巨大型腰椎间盘突出症（LDH）减压中的应用效果。
方法：该研究纳入了56例连续的单节段大量LDH患者，这些患者于2019年10月至2022年10月在大学医院接受了3D外镜辅助减压。分析基于围手术期指标的比较，包括减压时间，减压期间估计的失血量（EBL）和术后住院时间（PLS）；临床结果，包括使用视觉模拟评分法（VAS）和Oswestry残疾指数（ODI）进行评估；以及再次手术和并发症的发生率。
结果：平均减压时间为28.35±8.93分钟（腰椎椎间融合术（LIF））和15.50±5.84分钟（开窗椎间盘切除术（LOVE手术）），减压期间平均EBL为42.65±12.42ml（LIF）和24.32±8.61ml（LOVE手术），平均PLS为4.56±0.82天（LIF）和2.00±0.65天（LOVE手术）。无脑脊液漏等并发症,神经根损伤和硬膜外血肿。所有接受3D外镜辅助减压的患者均随访6个月。在最后一次随访中，术前至末次随访,VAS和ODI评分均有明显改善(P<0.05)。
结论：3D外镜提供了视觉上详细的，深而清晰的手术野，这使得减压更安全，更有效，并减少短期并发症。在单段大量LDH的解压缩期间，3D外镜可能是一个很好的辅助工具。
方法：该研究纳入了56例连续的单节段大量LDH患者，这些患者于2019年10月至2022年10月在大学医院接受了3D外镜辅助减压。分析基于围手术期指标的比较，包括减压时间，减压期间估计的失血量（EBL）和术后住院时间（PLS）；临床结果，包括使用视觉模拟评分法（VAS）和Oswestry残疾指数（ODI）进行评估；以及再次手术和并发症的发生率。
结果：平均减压时间为28.35±8.93分钟（腰椎椎间融合术（LIF））和15.50±5.84分钟（开窗椎间盘切除术（LOVE手术）），减压期间平均EBL为42.65±12.42ml（LIF）和24.32±8.61ml（LOVE手术），平均PLS为4.56±0.82天（LIF）和2.00±0.65天（LOVE手术）。无脑脊液漏等并发症,神经根损伤和硬膜外血肿。所有接受3D外镜辅助减压的患者均随访6个月。在最后一次随访中，术前至末次随访,VAS和ODI评分均有明显改善(P<0.05)。
结论：3D外镜提供了视觉上详细的，深而清晰的手术野，这使得减压更安全，更有效，并减少短期并发症。在单段大量LDH的解压缩期间，3D外镜可能是一个很好的辅助工具。
