单侧双通道内镜治疗颈胸交界处椎间盘突出症△（开放获取）

Unilateral biportal endoscopy for cervicothoracic junction disc herniation

摘要:

［目的］ 介绍单侧双通道内镜 （unilateral biportal endoscopy, UBE） 技术治疗颈胸交界处椎间盘突出症的手术技术和初步临床效果。［方法］ 对颈胸交界处椎间盘突出的 8 例患者进行脊柱内镜单侧双通道技术。C 形臂 X 线机透视下确定观察、 工作通道，磨除 C7下缘、T1上缘部分椎板、侧块，切除部分黄韧带，用神经钩钩出突出的髓核组织，髓核钳取出脱出的椎间盘，减压硬膜囊和神经根。［结果］ 8 例患者均顺利完成手术，未发生严重并发症，如硬膜或神经根损伤，手术时间 （152.0± 18.0）min；术中出血量（37.5±4.6）mL；术后住院时间（4.6±0.5）d。所有患者切口均实现一期愈合。所有患者在 6 个月的随访中颈部疼痛均消失或明显缓解，肢体无力和感觉减退症状较术前均明显减轻。［结论］UBE 技术在治疗颈胸交界处椎间盘突出症中技术可行，同时并发症发生率较低，具有良好的临床效果。

Abstract:

[Objective] To introduce the surgical technique and preliminary clinical outcome of unilateral biportal endoscopy (UBE) for cervicothoracic junction disc herniation. [Methods] A total of 8 patients received UBE discectomy for cervicothoracic disc herniation. The observation and working tubes were placed under guidance of fluoroscopy. Under the endoscopy, part of the lamina and lateral mass were removed at the lower edge of C7 and the upper edge of T1, and part of the yellow ligament was also excised to expose the protruding nucleus pulposus tissue. After the protruding disc was removed by nerve hook and forceps, the dural sac and nerve root were decompressed completely. [Results] All the 8 patients had endoscopic discectomy performed successfully without serious complications such as dural or nerve root injury, while with operation time of (152.0±18.0) minutes, intraoperative blood loss of (37.5±4.6) mL, postoperative hospital stay of (4.6±0.5) days and achieved primary wound healing. During the follow-up lasting for more than 6 months after operation, all patients had neck pain disappeared and significantly improved symptoms of limb weakness and hypoesthesia compared with those before surgery. [Conclusion] UBE technique is feasible in the treatment of cervicothoracic junction disc herniation, and has a low complication rate, and a good preliminary clinical consequence