Full-Endoscopic Foraminal Decompression for Foraminal Stenosis Following Osteoporotic Vertebral Fracture in an Elderly Woman Under Local Anesthesia:A Case Report.

IF 0.7 Q4 MEDICINE, RESEARCH & EXPERIMENTAL JOURNAL OF MEDICAL INVESTIGATION Pub Date : 2024-01-01 DOI:10.2152/jmi.71.179
Yu Otake, Fumitake Tezuka, Kazuta Yamashita, Masatoshi Morimoto, Kosuke Sugiura, Makoto Takeuchi, Shunsuke Tamaki, Junzo Fujitani, Hiroshi Kageyama, Koichi Sairyo
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Abstract

Osteoporotic vertebral fracture (OVF) is common in the elderly population. In this report, we describe a case with radiculopathy due to foraminal stenosis caused by OVF in a very elderly patient that was treated successfully by full-endoscopic foraminotomy under local anesthesia. The patient was an 89-year-old woman who presented with a chief complaint of left leg pain for 5 years. She visited a couple of hospitals and finally consulted us to determine the exact cause of the pain. Computed tomography scans were obtained and selective nerve root block at L3 was performed. The diagnosis was radiculopathy at L3 due to foraminal stenosis following OVF. The patient had severe heart disease, so we decided to avoid surgery under general anesthesia and planned full-endoscopic spine surgery under local anesthesia. We performed transforaminal full-endoscopic lumbar foraminotomy at L3-L4 to decompress the L3 nerve root. The leg pain disappeared completely immediately after surgery. Postoperative computed tomography confirmed appropriate bone resection. The leg pain did not recur during a year of postoperative follow-up. OVF may cause lumbar radiculopathy as a result of foraminal stenosis, and transforaminal full-endoscopic lumbar foraminotomy under local anesthesia would be the best option in an elderly patient with poor general condition. J. Med. Invest. 71 : 179-183, February, 2024.

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在局部麻醉下用全内窥镜椎间孔减压术治疗老年女性骨质疏松性椎体骨折后的椎间孔狭窄:病例报告。
骨质疏松性脊椎骨折(OVF)在老年人群中很常见。在本报告中,我们描述了一例因 OVF 导致椎间孔狭窄而引起的根神经病变,该病例在局麻下通过全内窥镜椎间孔切开术获得了成功治疗。患者是一名 89 岁的女性,主诉左腿疼痛 5 年。她去过几家医院就诊,最后到我院就诊,以确定疼痛的确切原因。我们为她进行了计算机断层扫描,并在 L3 处进行了选择性神经根阻滞。诊断结果显示,L3 椎弓根病是由椎间孔狭窄引起的。患者患有严重的心脏病,因此我们决定避免在全身麻醉下进行手术,计划在局部麻醉下进行全内窥镜脊柱手术。我们在 L3-L4 处进行了经椎间孔全内镜腰椎椎板切除术,为 L3 神经根减压。术后腿部疼痛立即完全消失。术后计算机断层扫描证实了适当的骨切除。术后随访一年,腿部疼痛未再复发。对于全身状况不佳的老年患者,经椎间孔镜全内镜腰椎椎板切除术是最佳选择。J. Med.Invest.71 : 179-183, February, 2024.
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来源期刊
JOURNAL OF MEDICAL INVESTIGATION
JOURNAL OF MEDICAL INVESTIGATION MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
1.20
自引率
0.00%
发文量
55
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