Unilateral Biportal Endoscopic Translaminar Keyhole Approach to Treat High-grade Up-migrated Lumbar Disc Herniation: Technical Note
單側雙通道脊柱內鏡下經椎板鎖孔入路治療高度向上游離型腰椎間盤突出的方法：技術說明
The incidence of lumbar disc fragment migration is approximately 35%–72% of which 34% are high-grade up-migrated discs. Translaminar keyhole approach is a minimally invasive and true tissue sparing technique which has been applied to approach migrated disc herniation. The unilateral biportal endoscopic approach is an emerging technique among endoscopic spine surgery that combines the advantages of microscopic surgery with endoscopic surgery. In this technical report we demonstrate the surgical technique of performing the translaminar keyhole approach with unilateral biportal endoscopic spine surgery to treat high-grade up-migrated discs. As far as we know, this is the first technical report of unilateral biportal endoscopy with translaminar keyhole approach to treat high-grade up migrated lumbar disc herniation.
腰椎間盤髓核游離的發生率約為35%-72%，其中34%是高度向上游離型腰椎間盤突出。椎板鎖孔入路是一種微創、真正保留組織的技術，已被應用于移行性椎間盤突出的入路。單側雙通道脊柱內鏡是脊柱內鏡手術中的一種新興技術。這結合了顯微鏡手術和內鏡手術的優點。在這個技術報告中我們展示了實施經椎板鎖孔入路的手術技術采用單側雙通道脊柱內鏡治療高度向上游離型腰椎間盤突出。據我們所知，這是第一個單側雙通道脊柱內鏡下經椎板鎖孔入路治療高度向上游離型腰椎間盤突出的技術報告。
CONCLUSION
The UBE translaminar keyhole approach is the combination of the minimally invasive endoscopic technique that permits the free movement of the dominant hand of the surgeon to realize precise and exact control of the instruments with the most segmental spinal stability-preserving and “straightforward” approach, to treat up-migrated lumbar disc herniations. The minimal anatomical disruption claimed by UBE, adding the benefit of translaminar approach to treat the up-migrated lumbar disc herniations allows access to the surgeon to difficult areas, with out compromising segmental spinal stability.
結論
UBE經椎板鎖孔入路是微創內鏡技術的結合，該技術允許外科醫生的慣用手自由運動，以實現對器械的精確和精確控制，并以脊柱節段性穩定和更“直接”的入路治療移位的腰椎間盤突出癥。報道稱UBE的解剖破壞最小，加上椎板間入路治療向上游離型腰椎間盤突出的優勢，能使外科醫生能進入更高難度區域，而不影響脊柱節段的穩定。
Key Words: Disc herniation, Intervertebral disc, Lumbar disc disease, Minimally invasive surgical Procedures
關鍵詞：椎間盤突出、椎間盤、腰椎間盤疾病、微創外科技術
