Clinical outcomes of percutaneous endoscopic surgery for lumbar discal cyst.
Clinical outcomes of percutaneous endoscopic surgery for lumbar discal cyst.
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DOI：
10.3340/jkns.2012.51.4.208
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发表时间：
2012-04
影响因子：
1.6
通讯作者：
Kim HS
中科院分区：
文献类型：
--
作者：
Ha SW;Ju CI;Kim SW;Lee S;Kim YH;Kim HS
椎间盘囊肿是一种罕见的疾病，其症状与腰椎间盘突出症难以区分。椎间盘囊肿的临床表现和病理特征尚未完全清楚。椎间盘囊肿可以通过手术或直接介入治疗，如计算机断层扫描（CT）引导下的抽吸和类固醇注射。本研究的目的是通过至少6个月的随访，评价经皮内窥镜手术治疗腰椎间盘囊肿的安全性和有效性。8例椎间盘囊肿伴神经根病患者均采用经椎间孔入路经皮内窥镜手术治疗。受累节段包括L5-S1 1例，L3-4 2例，L4-5 5例。所有病例术前的磁共振成像和三维CT椎间盘造影图像显示囊肿与受累椎间盘之间存在联系。在6个月的时间内，使用结局问卷对自我报告的措施进行评估，该问卷包括与背部相关的医疗资源利用和腿部疼痛的改善[视觉模拟量表（VAS）和Macnab标准]。所有8例患者均接受了内窥镜下囊肿切除术和附加的部分椎间盘切除术。7例患者在内镜下囊肿切除后症状立即缓解。随访期间无复发病灶。术前平均下肢疼痛VAS为8.25±0.5。在随访超过6个月的末次检查时，腿部疼痛的平均VAS为2.25±2.21。按MacNab标准，优4例（50%），良3例（37.5%），满意7例（87.5%）。然而，1例患者的治疗效果不理想，出现持续性下肢疼痛，另1例患者出现感觉异常。经椎间孔入路内镜下囊肿切除术后，大多数患者的神经根症状立即得到明显改善。
Discal cyst is rare and causes indistinguishable symptoms from lumbar disc herniation. The clinical manifestations and pathological features of discal cyst have not yet been completely known. Discal cyst has been treated with surgery or with direct intervention such as computed tomography (CT) guided aspiration and steroid injection. The purpose of this study is to evaluate the safety and efficacy of the percutaneous endoscopic surgery for lumbar discal cyst over at least 6 months follow-up. All 8 cases of discal cyst with radiculopathy were treated by percutaneous endoscopic surgery by transforaminal approach. The involved levels include L5-S1 in 1 patient, L3-4 in 2, and L4-5 in 5. The preoperative magnetic resonance imaging and 3-dimensional CT with discogram images in all cases showed a connection between the cyst and the involved intervertebral disc. Over a 6-months period, self-reported measures were assessed using an outcome questionaire that incorporated total back-related medical resource utilization and improvement of leg pain [visual analogue scale (VAS) and Macnab's criteria]. All 8 patients underwent endoscopic excision of the cyst with additional partial discectomy. Seven patients obtained immediate relief of symptoms after removal of the cyst by endoscopic approach. There were no recurrent lesions during follow-up period. The mean preoperative VAS for leg pain was 8.25±0.5. At the last examination followed longer than 6 month, the mean VAS for leg pain was 2.25±2.21. According to MacNab' criteria, 4 patients (50%) had excellent results, 3 patients (37.5%) had good results; thus, satisfactory results were achieved in 7 patients (87.5%). However, one case had unsatisfactory result with persistent leg pain and another paresthesia. The radicular symptoms were remarkably improved in most patients immediately after percutaneous endoscopic cystectomy by transforaminal approach.
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影响因子：
4.1
作者：
MAYER, HM;BROCK, M
通讯作者：
BROCK, M
影响因子：
2.1
作者：
Lee, Ho Kyu;Lee, Deok Hee;Rhim, Seung Chul
通讯作者：
Rhim, Seung Chul
影响因子：
3
作者：
Chiba, K;Toyama, Y;Nishizawa, T
通讯作者：
Nishizawa, T
影响因子：
3
作者：
BAKER, JK;HANSON, GW
通讯作者：
HANSON, GW
影响因子：
4.8
作者：
Ozer, Ali F.;Oktenoglu, Tunc;Sarioglu, Ali C.
通讯作者：
Sarioglu, Ali C.