State-of-the-art transforaminal percutaneous endoscopic lumbar surgery under local anesthesia: Discectomy, foraminoplasty, and ventral facetectomy
State-of-the-art transforaminal percutaneous endoscopic lumbar surgery under local anesthesia: Discectomy, foraminoplasty, and ventral facetectomy
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DOI：
10.1016/j.jos.2017.10.015
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发表时间：
2018-03-01
影响因子：
1.7
通讯作者：
Nagamachi, Akihiro
中科院分区：
文献类型：
--
作者：
Sairyo, Koichi;Chikawa, Takashi;Nagamachi, Akihiro
日本于2003年开始在局部麻醉下对腰椎进行经椎间孔（TF）经皮内窥镜手术。由于它只需要一个8毫米的皮肤切口，对椎旁肌肉的损伤最小，因此它将是目前侵入性最小的脊柱手术。最初，该技术用于椎间盘切除术;因此，该手术被称为PELD（经皮内窥镜腰椎间盘切除术）。TF入路可以在局麻下完成，有很大的好处。在手术过程中，患者将处于清醒和意识状态，因此，可以避免严重的神经根损伤。此外，该手术对于全身状况不佳的老年患者是可能的，这不允许全身麻醉。历史上，该技术首先应用于突出的髓核。然后，由于高速钻头的发展，椎间孔成形术，即狭窄椎间孔的扩大手术成为可能。它被称为经皮内窥镜腰椎椎间孔成形术（PELF）。最近，该技术被应用于侧隐窝狭窄的修复，该技术被命名为经皮内窥镜腹侧关节面切除术（PEVF）。在这篇综述文章中，我们详细解释了手术技术的发展与时间，并显示我们的典型病例。(c)2017年日本骨科协会。由爱思唯尔公司出版
Transforaminal (TF) percutaneous endoscopic surgery for the lumbar spine under the local anesthesia was initiated in 2003 in Japan. Since it requires only an 8-mm skin incision and damage of the paravertebral muscles would be minimum, it would be the least invasive spinal surgery at present. At the beginning, the technique was used for discectomy; thus, the procedure was called PELD (percutaneous endoscopic lumbar discectomy). TF approach can be done under the local anesthesia, there are great benefits. During the surgery patients would be in awake and aware condition; thus, severe nerve root damage can be avoided. Furthermore, the procedure is possible for the elderly patients with poor general condition, which does not allow the general anesthesia. Historically, the technique was first applied for the herniated nucleus pulposus. Then, foraminoplasty, which is the enlargement surgery of the narrow foramen, became possible thanks to the development of the high speed drill. It was called the percutaneous endoscopic lumbar foraminoplasty (PELF). More recently, this technique was applied to decompress the lateral recess stenosis, and the technique was named percutaneous endoscopic ventral facetectomy (PEVF). In this review article, we explain in detail the development of the surgical technique of with time with showing our typical cases. (c) 2017 The Japanese Orthopaedic Association. Published by Elsevier B.V.