A novel surgical concept of transforaminal full-endoscopic lumbar undercutting laminectomy (TE-LUL) for central canal stenosis of the lumbar spine with local anesthesia : A case report and literature review.
A novel surgical concept of transforaminal full-endoscopic lumbar undercutting laminectomy (TE-LUL) for central canal stenosis of the lumbar spine with local anesthesia : A case report and literature review.
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局麻下经椎间孔全内窥镜腰椎底切椎板切除术（TE-LUL）治疗腰椎中央管狭窄的新手术理念：病例报告和文献综述。
DOI：
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发表时间：
2019
影响因子：
0.7
通讯作者：
Toru Maeda
中科院分区：
文献类型：
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作者：
K. Sairyo;Kazuta Yamashita;H. Manabe;Y. Ishihama;K. Sugiura;Fumitake Tezuka;Y. Takata;T. Sakai;Yasuyuki Omichi;Nobutoshi Takamatsu;Ayaka Hashimoto;Toru Maeda
全内窥镜脊柱手术最初是为腰椎髓核突出而开发的。全内窥镜腰椎手术主要有两种类型： 经椎间孔（TF）和椎板间入路。TF入路可在局麻下完成手术，因此，我们需要进一步发展TF入路以适应各种脊柱疾病。 近年来，TF全内窥镜手术已应用于椎管狭窄症的治疗。首先，经椎间孔全内窥镜腰椎椎间孔成形术治疗椎间孔狭窄;然后，经椎间孔腰椎侧隐窝减压术治疗侧隐窝狭窄。 最后，我们发展了局部麻醉下经TF入路切除中央狭窄的手术技术。在开始临床病例之前，我们已经尝试使用新鲜尸体脊柱进行腰椎椎板切除术。在我们从技术上证实经椎间孔全内窥镜腰椎椎板切除术（TE-LUL）是可行的之后，我们将该技术应用于肺容量不允许全身麻醉的患者。一位72岁的女性中央管狭窄患者，在局麻下接受TE-LUL后，其左腿疼痛和肌无力可得到改善。本文介绍了TE-LUL的手术技术，并讨论了TE-LUL的疗效。J. Med. Invest. 66：224-229，2019年8月。
Full-endoscopic spinal surgery was first developed for the lumbar herniated nucleus pulposus. Mainly, there are two types in the full-endoscopic lumbar surgery : i.e., transforaminal (TF) and interlaminar approach. The surgery can be done under the local anesthesia for the TF approach ; therefore, we need to further develop the TF approach to variety of the spinal disorders. Recently, the TF full-endoscopic surgery has been applied for the spinal canal stenosis. First, transforaminal full-endoscopic lumbar foraminoplasty for the foraminal stenosis ; then, transforaminal lumbar lateral recess decompression for the lateral recess stenosis has been developed. Finally, we have developed the surgical technique to decompress the central stenosis via TF approach under the local anesthesia. Prior to initiate the clinical case, we have attempted the lumbar undercutting laminectomy using a fresh cadaveric spine. After we technically confirmed that the transforaminal full-endoscopic lumbar undercutting laminectomy (TE-LUL) is possible, we applied the technique to the patient whose lung capacity did not allow general anesthesia. The 72 years old female patient with central canal stenosis could be improved her left leg pain and muscle weakness after TE-LUL under the local anesthesia. In this paper, we introduce the surgical technique of the TE-LUL and discuss of the efficacy of the TE-LUL. J. Med. Invest. 66 : 224-229, August, 2019.