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首页> 外文期刊>Neurosurgical focus >Thoracoscopic discectomy and instrumented fusion using a minimally invasive plate system: Surgical technique and early clinical outcome
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Thoracoscopic discectomy and instrumented fusion using a minimally invasive plate system: Surgical technique and early clinical outcome

机译：胸腔镜椎间盘切除术和使用微创钢板系统的器械融合：手术技术和早期临床结果

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Object: The use of minimally invasive noninstrumented fusions has increased as thoracoscopic approaches to the spine have evolved. The addition of instrumentation is infrequent, in part because of the lack of a minimally invasive implant system. The authors describe a technique for thoracoscopic plating after discectomy and report early clinical outcomes. Methods: After a standard endoscopic discectomy and partial corpectomy and before exposure of the ventral thecal sac, the authors implanted a polyaxial screw and clamping element under fluoroscopic guidance. Reconstruction involves placement of autograft in the defect and subsequent placement of the remainder of the screw/plate construct with 2 screws per vertebral level. Results: Twenty-five patients underwent thoracoscopic and thoracoscopy-assisted discectomies and fusion in which the aforementioned plate system was used. Of 19 patients presenting with pain, 10 had 6-month clinical follow-up with a greater than 50% reduction in visual analog scale score, which continued to improve up to 2 years postoperatively. There were 3 cases of pneumonia, 3 CSF leaks, 1 chyle leak, and 1 death due to a massive pulmonary embolus on the 1st postoperative day. Conclusions: The authors conclude that thoracoscopic discectomy and plate-instrumented fusion can be achieved with acceptable results and morbidity. Further studies should evaluate the role of instrumented fusions after thoracoscopic discectomy in larger groups of patients and during a longer follow-up period.
机译：目的：随着胸腔镜对脊柱方法的发展，微创非器械融合的使用也有所增加。很少添加仪器，部分原因是缺少微创植入系统。作者介绍了一种在椎间盘切除术后进行胸腔镜电镀的技术，并报告了早期的临床结果。方法：在标准的内镜下椎间盘切除术和部分体切除术之后，以及在腹侧鞘囊暴露之前，作者在荧光镜的引导下植入了多轴螺钉和夹紧元件。重建包括将自体移植物放置在缺损处，然后将剩余的螺钉/板结构的每个椎骨水平放置2个螺钉。结果：25例患者接受了胸腔镜和胸腔镜辅助的切开并融合术，其中使用了上述钢板系统。在19例疼痛患者中，有10例接受了6个月的临床随访，视觉模拟量表评分降低了50％以上，并且在术后2年内持续改善。术后第一天出现肺炎3例，脑脊液漏3例，乳糜1例，大量肺栓塞致死1例。结论：作者得出的结论是，胸腔镜下椎间盘切除术和板状器械融合可以达到满意的结果和发病率。进一步的研究应评估胸腔镜下椎间盘切除术后更大范围的患者以及更长的随访期间仪器融合的作用。

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