Zina percutaneous screw fixation combined with endoscopic lumbar intervertebral fusion under intraoperative neuromonitoring: A case report
| Autor: | Hai-Chi Yu, Jun Zhang, Tao He, Rui Liu, Jiu-Ping Wu, Derui Xu, Tong Yu, Qinyi Liu, Tianyang Yuan, Zhi-He Yun |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty endoscopic Nerve root Intraoperative Neurophysiological Monitoring Decompression Visual analogue scale medicine.medical_treatment Bone Screws lumbar disc herniation 03 medical and health sciences 0302 clinical medicine Lumbar Discectomy medicine Humans 030212 general & internal medicine Clinical Case Report Lumbar Vertebrae business.industry Soft tissue Endoscopy General Medicine Middle Aged medicine.disease Oswestry Disability Index Surgery Spinal Fusion percutaneous 030220 oncology & carcinogenesis Soft tissue injury minimally invasive lumbar intervertebral fusion business Intervertebral Disc Displacement Research Article |
| Zdroj: | Medicine |
| ISSN: | 1536-5964 |
| Popis: | Introduction: Traditional open discectomy and intervertebral fusion surgery is the common strategy for lumbar disc herniation (LDH). However, it has the disadvantages of long recovery time and severe paravertebral soft tissue injury. Zina percutaneous screw fixation combined with endoscopic lumbar intervertebral fusion (ZELIF), as a novel minimally invasive surgical technique for LDH, has the advantages in quicker recovery, less soft tissue destruction, shorter hospital stays and less pain. We report a novel technique of ZELIF under intraoperative neuromonitoring (INM) for the treatment of LDH. Patient concerns: A 51-year-old male presented to our hospital with left lower extremity pain and numbness for 1 year. Diagnosis: Lumbar disc herniation (LDH). Interventions: This patient was treated with Zina percutaneous screw fixation combined with endoscopic neural decompression, endplate preparation, and intervertebral fusion through Kambin's triangle. Each step of the operation was performed under INM. Outcomes: The follow-up period lasted 12 months; the hospitalization lasted 4 nights; the blood loss volume was 65 ml, and the time of operation was 266 min. INM showed no neurological damage during the surgery. No surgical complications, including neurological deterioration, cage migration, non-union, instrumentation failure or revision operation, were observed during the follow-up period. Visual Analogue Scale (VAS) score reduced from 7 to 1; the Oswestry Disability Index (ODI) decreased from 43 to 14; the EQ-5D score was 10 preoperatively and 15 at the final follow-up visit; the Physical Component Summary of the 36-Item Short Form Health Survey (SF-36) was 48 preoperatively and 49 at the last follow up visit; the SF-36 Mental Component Summary was 47 before surgery and decreased to 41 postoperatively. Conclusion: ZELIF under INM may represent a feasible, safe and effective alternative to endoscopic intervertebral fusion and percutaneous screw fixation, for decompressing the lumbar's exiting nerve root directly with minimal invasion in selected patients. |
| Databáze: | OpenAIRE |
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