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Endoscopic decompression of a C1 osteophyte causing bow hunter’s syndrome in a 22-year-old male 为一名 22 岁男性实施 C1 骨质增生内窥镜减压术,引发猎弓者综合征
Pub Date : 2024-04-01 DOI: 10.3171/2024.1.focvid23234
Zachary A. Abecassis, John I. Ogunlade, Whitney Teagle, Guilherme Barros, Christine Park, Michael R. Levitt, C. P. Hofstetter
The patient is a 22-year-old male with a history of C1 avulsion fracture causing vertebral artery compression with pseudoaneurysm and symptomatic stroke. Cerebral angiography demonstrated dynamic compression of the V3 segment of the vertebral artery due to a chronic C1 avulsion fracture. The authors utilized a full endoscopic approach with intraoperative angiography for proximal control and Doppler ultrasound to confirm adequate decompression. The surgery duration was 3 hours with blood loss < 5 ml. The patient was discharged on postoperative day 1 with no complication and has been asymptomatic since surgery. This is the first documented use of endoscopic decompression to treat this condition. The video can be found here: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23234
患者是一名22岁的男性,曾因C1撕脱性骨折导致椎动脉受压并伴有假性动脉瘤和无症状中风。脑血管造影显示,慢性C1撕脱骨折导致椎动脉V3段动态压迫。作者采用全内窥镜方法,术中通过血管造影进行近端控制,并通过多普勒超声确认减压是否充分。手术时间为 3 小时,失血量小于 5 毫升。患者术后第 1 天出院,无并发症,术后一直无症状。这是首次有记录地使用内窥镜减压术治疗这种疾病。视频请点击: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23234
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引用次数: 0
Advancements in technique and technology of minimally invasive and endoscopic spine surgery 微创和内窥镜脊柱外科技术的进步
Pub Date : 2024-04-01 DOI: 10.3171/2024.1.focvid23218
M. Mahan, Hyeun-Sung (Harrison) Kim, Laura A Snyder, R. Fessler
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引用次数: 0
Biportal endoscopic posterior cervical foraminotomy with discectomy for unilateral radicular arm pain due to cervical herniated disc 双腔内窥镜颈椎后椎板切除术联合椎间盘切除术治疗颈椎间盘突出导致的单侧手臂根性疼痛
Pub Date : 2024-04-01 DOI: 10.3171/2024.1.FOCVID23225
Dong Hwa Heo
Recently, biportal endoscopic cervical approaches have been used to treat cervical degenerative disease. Biportal endoscopic posterior cervical foraminotomy with or without discectomy has the advantage of reducing damage to the normal tissues during surgery and enhancing fast recovery after surgery. The biportal endoscopic cervical approach was performed using two portals. The first portal was an endoscopic viewing portal for the spinal endoscope, and the other portal was a working portal for using surgical instruments. The author illustrates the surgical technique of biportal endoscopic posterior cervical foraminotomy with discectomy. The video can be found here: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23225
近来,双ortal内窥镜颈椎方法被用于治疗颈椎退行性疾病。双ortal内窥镜颈椎后椎板切除术(带或不带椎间盘切除术)具有手术过程中减少对正常组织损伤、术后恢复快的优点。双门内窥镜颈椎手术采用两个入口进行。第一个入口是脊柱内窥镜的内窥镜观察入口,另一个入口是使用手术器械的工作入口。作者展示了双入口内窥镜颈椎后椎板切除术和椎间盘切除术的手术技巧。视频请点击: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23225
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引用次数: 0
Surgical management of tethered spinal cord syndrome through biportal endoscopic approach: a novel technical note 通过双入口内窥镜手术治疗系带脊髓综合征:新颖的技术说明
Pub Date : 2024-04-01 DOI: 10.3171/2024.1.FOCVID23228
Mehmet İlker Özer, Mehmet Can Ezgü, Ali Kaplan, Zeliha Çulcu Gürcan, Oğuz Kağan Demirtaş
This video article explores a case of tethered cord release through a minimally invasive biportal endoscopic approach. A 24-year-old female with chronic back pain and thigh numbness underwent surgery. The chosen approach involved biportal endoscopic technique, demonstrating precision with minimal bone excision. Preoperative imaging revealed a midline fusion defect at L5 and abnormal conus medullaris termination. The surgical procedure involved one-sided hemilaminectomy, durotomy, and careful filum terminale separation. Postoperatively, radiological exams confirmed success with minimal bone defect. Emphasizing minimal invasiveness, reduced bone excision, and muscle sparing, this technique showcased successful outcomes, enabling the patient’s rapid postoperative recovery without complications. The video can be found here: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23228
本视频文章探讨一例通过双入口内窥镜微创方法进行系带松解的病例。一名 24 岁的女性因长期背痛和大腿麻木接受了手术。选择的方法是双ortal内窥镜技术,该技术精确度高,只需切除极少量的骨头。术前造影显示 L5 椎体中线融合缺损,髓圆锥终止异常。手术过程包括单侧半椎板切除术、穹隆切除术和仔细的髓丝分离术。术后,放射学检查证实手术成功,骨缺损极小。该技术强调微创、减少骨切除和肌肉保护,取得了成功的结果,使患者术后恢复迅速,无并发症发生。视频请点击:https://stream.cadmore.media/r10.3171/2024.1.FOCVID23228
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引用次数: 0
Biportal endoscopic transforaminal lumbar interbody fusion using a large cage for degenerative spondylolisthesis with stenosis 双腔内窥镜经椎间孔腰椎椎体间融合术(使用大椎笼)治疗伴有狭窄的退行性脊椎滑脱症
Pub Date : 2024-04-01 DOI: 10.3171/2024.1.FOCVID23231
Dong Hwa Heo
Recently, biportal endoscopic transforaminal lumbar interbody fusion (TLIF) has been used to treat lumbar degenerative diseases, such as lumbar instability and spondylolisthesis. Biportal endoscopic TLIF may have the advantages of endoscopic spine approaches and minimally invasive lumbar fusion surgeries. In this biportal endoscopic TLIF, large cages similar to oblique lumbar interbody fusion (OLIF) cages have been used. Biportal endoscopic TLIF using a large cage can be successfully performed in the lower lumbar area. The author presents the surgical technique of biportal endoscopic TLIF using a large cage. The video can be found here: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23231
最近,双ortal 内窥镜经椎间孔腰椎椎体融合术(TLIF)被用于治疗腰椎退行性疾病,如腰椎不稳和脊椎滑脱症。双ortal内窥镜TLIF可能具有内窥镜脊柱方法和微创腰椎融合手术的优点。在这种双ortal 内窥镜 TLIF 中,使用了类似于斜行腰椎椎体间融合(OLIF)笼的大笼。双ortal 内窥镜 TLIF 使用大型椎体笼,可在下腰椎区域成功实施。作者介绍了使用大型保持架的双ortal内窥镜TLIF手术技术。视频请点击: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23231
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引用次数: 0
Minimally invasive anterior cervical foraminotomy for unilateral radiculopathy 微创颈椎前路椎板切除术治疗单侧根性神经根病
Pub Date : 2024-04-01 DOI: 10.3171/2024.1.FOCVID23196
Duncan J. Trimble, D. Sheinberg, Joseph A. Cochran
Anterior cervical foraminotomy (ACF) is an alternative surgical option for the treatment of refractory unilateral radiculopathy due to disc herniation or spondylosis. The efficacy and adverse event rate in experienced practitioners are comparable to those of anterior cervical discectomy and fusion, total disc arthroplasty, and posterior foraminotomy. However, this technique has not been widely adopted, likely because of the proximity of the working zone and the vertebral artery. The authors present a detailed operative video of a patient successfully treated with an ACF. They also present a review of the ACF literature. The video can be found here: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23196
颈椎前路椎板切除术(ACF)是治疗椎间盘突出症或脊椎病引起的难治性单侧根性神经病的另一种手术选择。在经验丰富的医生中,其疗效和不良事件发生率与颈椎椎间盘前路切除融合术、全椎间盘关节成形术和后椎板切除术相当。然而,这项技术尚未被广泛采用,可能是因为工作区与椎动脉距离较近。作者展示了一位成功接受 ACF 治疗的患者的详细手术视频。他们还对 ACF 文献进行了回顾。视频可在此处找到: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23196
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引用次数: 0
Percutaneous full-endoscopic bullet removal from the C2 vertebra in a pediatric patient 一名儿童患者的 C2 脊椎经皮全内窥镜子弹取出术
Pub Date : 2024-04-01 DOI: 10.3171/2024.1.focvid23230
Özkan Çeliker, Yücel Doğruel
Gunshot injuries (GSIs) to the spine constitute approximately 17% to 21% of all traumatic spinal injuries, with the cervical spine being the second most frequently affected region. There is a lack of approved algorithms for patients with GSIs to the spine. Surgical intervention is controversial; however, it is generally considered in cases involving neurological deterioration with incomplete deficit, externalized liquor fistula, instability, installed toxicity, and risk of migration. Detailed information on pediatric patients is limited, primarily due to the predominance of adult patients. This study presents the full-endoscopic removal of a bullet in the C2 vertebra of a pediatric patient. The video can be found here: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23230
脊柱枪伤(GSI)约占所有脊柱外伤的 17% 至 21%,颈椎是第二大最常受影响的部位。目前还没有针对脊柱 GSI 患者的公认算法。手术干预是有争议的;但是,一般在涉及神经系统恶化并伴有不完全缺损、外瘘、不稳定、安装毒性和移位风险的病例中会考虑手术干预。有关儿童患者的详细信息非常有限,这主要是由于成人患者居多。本研究介绍了在全内窥镜下取出一名儿童患者C2椎体内子弹的手术。视频请点击: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23230
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引用次数: 0
MIS technique for separation surgery in lumbar spine metastatic disease 腰椎转移性疾病分离手术的 MIS 技术
Pub Date : 2024-04-01 DOI: 10.3171/2024.1.FOCVID23222
Vicente de Paulo Martins Coelho Junior, Joravar Dhaliwal, Vikram B. Chakravarthy
Around 40% of cancer patients present with spinal metastases (SM), the lumbar spine being the second most involved site (15%–30%) after the thoracic (60%–80%). Since the development of separation surgery, minimally invasive surgery (MIS) has increasingly been applied to approach SM, mirroring benefits yielded in the degenerative realm. Moreover, preoperative embolization potentially enhances local control for certain radioresistant histologies. Carbon fiber–reinforced PEEK hardware reduces image artifact, facilitating more accurate follow-up and radiotherapeutic planning. Additionally, short-segment cement-augmented constructs may be beneficial to decrease surgical morbidity and operative risk in this population. The authors present a lumbar spinal metastasis treated with MIS techniques. The video can be found here: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23222
约 40% 的癌症患者会出现脊柱转移(SM),腰椎是第二大受累部位(15%-30%),仅次于胸椎(60%-80%)。自分离手术发展以来,微创手术(MIS)越来越多地被应用于脊柱转移瘤的治疗,这与退行性病变领域所取得的疗效如出一辙。此外,术前栓塞可增强对某些抗放射组织的局部控制。碳纤维加固的PEEK硬件可减少图像伪影,便于进行更准确的随访和放射治疗规划。此外,短节段水泥增强结构可能有利于降低这类人群的手术发病率和手术风险。作者介绍了用 MIS 技术治疗腰椎转移瘤的情况。视频请点击: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23222
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引用次数: 0
Combined unilateral biportal endoscopy and video-assisted thoracoscopic surgery for complete excision of a T3–T4 right ganglioneuroma 联合单侧双ortal内窥镜和视频辅助胸腔镜手术彻底切除右侧T3-T4神经节瘤
Pub Date : 2024-04-01 DOI: 10.3171/2024.2.focvid23210
Enrico Giordan, Changik Lee, Dimas Rahman Setiawan, Phattareeya Pholprajug, Jin-Sung Kim
Ganglioneuroma (GN) is a rare solid neoplasm developing from neural crest cells of sympathetic ganglia or adrenal medulla. It usually presents as an asymptomatic mass in the retroperitoneal space and mediastinum. Resection through open surgery or minimal access is recommended. The video illustrates the case of a 23-year-old female with an incidental finding of thoracic GN. The authors performed a combined, staged approach to ensure complete resection, which involved unilateral T3–4 biportal endoscopy (UBE) for rhizotomy and nerve root decompression, followed by video-assisted thoracoscopic surgery (VATS) for complete excision. The procedure was uneventful, with full recovery and no postoperative complications. The video can be found here: https://stream.cadmore.media/r10.3171/2024.2.FOCVID23210
神经节瘤(GN)是一种罕见的实体瘤,由交感神经节或肾上腺髓质的神经嵴细胞发展而来。它通常表现为腹膜后间隙和纵隔内无症状的肿块。建议通过开腹手术或微创手术进行切除。视频中的病例是一名 23 岁女性,偶然发现胸部 GN。作者采用了分阶段的联合方法确保彻底切除,包括单侧 T3-4 双ortal 内镜(UBE)根治术和神经根减压,然后采用视频辅助胸腔镜手术(VATS)彻底切除。手术过程顺利,患者完全康复,术后无并发症。视频请点击: https://stream.cadmore.media/r10.3171/2024.2.FOCVID23210
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引用次数: 0
Full endoscopic resection of large bilateral synovial cysts in lumbar spine 腰椎双侧大滑膜囊肿全内窥镜切除术
Pub Date : 2024-04-01 DOI: 10.3171/2024.1.FOCVID23208
Jannik Leyendecker, Nelson Sofoluke, C. P. Hofstetter, Sanjay Konakondla
Synovial spinal cysts cause radiculopathy and back pain, with rare reports of cauda equina syndrome. Hypermobility and instability are cornerstones for synovial cyst formation. The incidence is around 5%, and data for bilateral cysts are lacking. Surgery is indicated after conservative measures fail. Recurrence is common and is potentially due to joint violation and destabilization from open surgery. This could be prevented via ultra-minimally invasive approaches. The authors present full endoscopic removal of bilateral synovial cysts in a patient with grade 1 stable spondylolisthesis and include a 360° view for confirmation of complete decompression. Postoperatively, the patient reported immediate pain relief. The video can be found here: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23208
滑膜脊柱囊肿会引起脊髓病变和背痛,马尾综合征的报告也很少见。过度活动和不稳定是滑膜囊肿形成的基础。发病率约为 5%,缺乏双侧囊肿的数据。在保守治疗无效后,应进行手术治疗。复发很常见,可能是由于开放手术造成的关节侵犯和不稳定。通过超微创方法可以避免复发。作者介绍了在内窥镜下切除双侧滑膜囊肿的病例,患者的脊柱滑脱程度为 1 级,病情稳定,并提供了 360° 视图以确认完全减压。术后,患者表示疼痛立即得到缓解。视频请点击:https://stream.cadmore.media/r10.3171/2024.1.FOCVID23208
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引用次数: 0
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Neurosurgical focus: Video
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