PDF(Pubmed)
Abstract：
Minimally invasive surgical approaches to the spine that leverage indirect decompression are gaining increasing popularity. While there is excellent literature on the value of indirect decompression, there are limitations to this procedure. Specifically, in patients with severe stenosis and neurogenic claudication, there is a concern among many surgeons regarding the adequacy of indirect decompression alone. In these cases, the lateral approach is often abandoned in favor of an open posterior or posterior minimally invasive approach. Unfortunately, some of the distinct benefits of the direct lateral approach are then lost. Here, we present the case of a 58-year-old male who underwent an L4-L5 lateral interbody fusion with an endoscopic ipsi-contra decompression to achieve both direct and indirect treatment of severe neuroforaminal and central stenosis. From this strategy, this patient had complete pre-operative symptom resolution and was able to return to work immediately after surgery without significant restriction. Combining the benefits of direct and indirect using an ultra-minimally invasive decompressive approach offers a potential solution.
摘要：
利用间接减压的脊柱微创手术方法越来越受欢迎。虽然关于间接减压的价值有很好的文献，这个程序有局限性。具体来说,严重狭窄和神经源性跛行的患者，许多外科医生担心单独的间接减压是否足够。在这些情况下,外侧入路通常被放弃，转而采用开放的后路或后路微创入路。不幸的是,直接横向进近的一些独特的好处就失去了。这里,我们介绍了1例58岁男性患者,该患者接受了L4-L5侧路椎间融合术和内镜下对位减压术,以直接和间接治疗严重的椎间神经和中央狭窄.从这个战略来看,该患者术前症状完全缓解,手术后可立即恢复工作,无明显限制.结合使用超微创减压方法的直接和间接的好处提供了一个潜在的解决方案。
