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磁共振成像在局部麻醉下进行远侧椎间盘的跨内镜腰椎间盘切除术中手术困难的预测者

Yong Ahn¹, Sungsoo Bae¹, Dae-Jean Jo¹

¹Department of Neurosurgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul 05278, Republic of Korea.

|April 29, 2025

概括

在手术前的MRI发现预测了远侧椎间盘的跨内镜腰椎切除术 (TELD) 的手术困难. 确定狭窄和带有助于优化手术策略和改善结果.

科学领域:

神经外科神经外科
整形外科手术整形外科手术
最少侵入性的脊柱手术

背景情况:

跨膜内镜腰椎切除术 (TELD) 为腰椎椎间板 (LDH) 提供了最少的侵入性益处.
远侧LDH由于TELD期间潜在的门狭窄和接入疼痛而带来了挑战.
对于远侧LDH的TELD中外科困难的预测因素需要确定.

研究的目的:

确定手术前磁共振成像 (MRI) 发现和人口因素,预测远侧LDH的TELD手术难度.
讨论手术策略的优化,以减轻诸如前狭窄和入口疼痛等挑战.
评估这些因素对手术数据和患者结果的影响.

主要方法:

追溯分析75名患有远侧LDH的患者进行TELD.
评估手术前的人口统计和MRI发现,包括前狭窄等级和带.
分析手术数据 (手术时间,住院时间,手术内疼痛) 和术后结果 (并发症,Macnab标准).

主要成果:

较高的甲状腺狭窄度与延长的手术时间和住院时间相关 (p < 0.01).
额外的LDH与由于神经根刺激而增加的接入疼痛有关 (p < 0.01).
接入疼痛与更长的手术时间和住院时间有显著的相关性 (p < 0.01).

结论:

在手术前的MRI发现,特别是膜收窄等级和带,预测外科手术的困难和远侧LDH的TELD的结果.
这些洞察力使得量身定制的外科手术策略能够最大限度地减少入口疼痛并提高手术成功率.
优化技术和疼痛管理对于在局部麻醉下成功进行TELD至关重要.

关键词:

进行内镜外科手术程序.额外的额外的腰椎间盘.额外的肌肉狭窄症局部麻醉局部麻醉腰椎腰椎腰椎腰椎腰椎磁共振成像技术的使用疼痛管理疼痛管理

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