脊柱内镜下腰椎管狭窄症减压手术现状与展望

Current status and prospects of spinal endoscopic decompression for lumbar spinal stenosis

腰椎管狭窄症(LSS)是一种常见的脊柱退变性疾病。在脊柱微创外科(MISS)理念的指导下,经过30余年的发展,脊柱内镜单侧椎板切开双侧减压(ULBD)技术取得了显著进步。该技术利用水介质,通过小切口实现对椎管的减压,并在保持脊柱稳定性的前提下,取得了满意的临床效果。然而,脊柱内镜下的椎管减压手术仍存在一些并发症,如神经损伤、硬膜囊撕裂、类脊髓高压反应和硬膜外血肿等。部分学者开始探索脊柱内镜机器人技术,以降低并发症、提高治疗效果。本文对脊柱内镜治疗LSS的现状进行了总结,旨在让手术医师充分了解和认识这种手术方式,以期为患者提供更好的治疗。

Lumbar spinal stenosis(LSS)is a common degenerative spinal disease.Over the past 30 years,under the concept of minimally invasive spine surgery(MISS),spinal endoscopy has seen significant advancements,particularly in endoscopic unilateral laminotomy for bilateral decompression(ULBD).This technique,utilizing a fluid medium and small incision,achieves spinal canal decompression while maintaining spinal stability,resulting in satisfactory clinical outcomes.However,endoscopic spinal decompression surgery still has some complications,such as nerve injury,dural tears,myeloid hypertension,and epidural hematomas.Some scholars have begun exploring robotic endoscopic spinal surgery to reduce complications and improve clinical outcomes.This article provides an overview of the current state of endoscopic treatment for LSS,aiming to equip surgeons with a comprehensive understanding of this surgical approach to deliver better patient care.