在中枢中发生的内椎间盘:一个病例报告,重点是患者定位和神经监测
Michael J Kelly1, Marco D Burkhard1, Franziska C S Altorfer1
1Department of Spine Surgery, Hospital for Special Surgery, New York, New York.
JBJS case connector
|January 22, 2025
概括
对于涉及椎间盘的脊柱手术,仔细的患者定位至关重要. 避免过度延伸和使用前置性神经监测可以确保在手术期间的神经安全.
科学领域:
- 神经外科 神经外科
- 脊柱外科手术 脊柱外科手术
- 神经监测是指神经系统的监测.
背景情况:
- 一名73岁的男性出现了反复出现的右根茎腿部疼痛.
- 图像检测显示,在L1-2处有一个大型的中央磁盘,怀疑有内延伸.
研究的目的:
- 描述一个脊柱外科手术的案例,用于内椎间盘.
- 突出患者定位和神经监测在预防神经性损害方面的重要性.
主要方法:
- 最初的手术尝试由于在Jackson框架上倾斜定位时运动信号减弱而被中止.
- 第二次手术尝试在将患者重新定位到中性/弹性位置后取得了成功,这使神经监测信号正常化.
- 在没有任何事件的情况下进行了内疗法和磁盘切除术.
主要成果:
- 在调整患者的位置后,成功实现了手术减压和椎间盘切除.
- 神经监测信号与中性/屈曲的患者姿势正常化,使程序成为可能.
结论:
- 在层内内椎间板需要仔细考虑患者的位置.
- 在定位过程中避免过度延伸,并利用前置性神经监测,对于这种情况下的神经安全至关重要.
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