"仅固定"在腰部通道狭窄的失败解压的情况下 - 分析14个病例的结果
Atul Goel1,2,3,4, Apurva Prasad1,5, Abhidha Shah4,6,7
1Department of Neurosurgery, Lilavati Hospital and Research Center, Mumbai, Maharashtra, India.
Journal of craniovertebral junction & spine
|January 25, 2024
概括
由于脊柱狭窄而失败的腰部减压手术可以通过"仅固定"脊柱稳定有效治疗. 这种方法解决了不稳定性,导致症状恢复和融合,而无需进一步减压.
科学领域:
- 神经外科 神经外科
- 整形外科手术 整形外科手术
- 脊柱外科手术 脊柱外科手术
背景情况:
- 腰椎通道狭窄症通常需要去压缩拉美切除术.
- 失败的去压膜切除术可能会导致症状持续或恶化.
- 多段腰道狭窄在初始减压后会带来独特的挑战.
研究的目的:
- 为了评估"仅固定"脊柱稳定在腰部通道狭窄的失败解压膜切除术的疗效.
- 为了确定单独稳定,没有进一步减压,可以解决症状.
- 在这个患者队列中评估细分脊柱稳定的长期结果.
主要方法:
- 对14名患有腰部管道狭窄的压缩性拉美切除术失败的患者进行了回顾性分析.
- 治疗包括使用Goel或Camille的面部固定进行细分脊柱稳定.
- 没有进行额外的骨,软组织或圆盘切除.
- 临床结果使用奥斯威斯特残疾指数和视觉模拟尺度进行评估,并补充了视频自我评估.
主要成果:
- 所有14名患者都经历了主要症状的恢复,手术后立即出现了改善.
- 平均随访时间为71个月,没有复发症状或需要修复手术.
- 在所有患者中都实现了坚定的稳定和骨融合的证据.
- 没有报告任何感染或植入失败;没有患者病情恶化.
结论:
- 脊柱不稳定是腰带通道狭窄失败减压的主要问题.
- "仅固定"脊柱稳定是一种有效的治疗策略.
- 仅靠稳定可以成功地控制症状,并在失败解压后促进融合.
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