Analysis of the curative effect of microchannel surgery on lumbar disc herniation under three-dimensional robotic digital microscope

doi:10.3877/cma.j.issn.2095-9141.2024.04.009

Abstract

Abstract:

Objective

To investigate the surgical technique and clinical effect of three -dimensional (3D) robotic digital microscope microchannel surgery for lumbar disc herniation (LDH).

Methods

The clinical data of 5 patients with LDH admitted to Neurosurgery Department of the First Affiliated Hospital of Shandong First Medical University from June to August 2023 were retrospectively analyzed. All 5 patients underwent 3D robotic digital microscope microchannel surgery. The degree of pain relief was evaluated by visual analogue scale (VAS) score 2 weeks after surgery. Spinal stability and facet joint injury were assessed by CT and 3D reconstruction of the lumbar spine. MacNab score was modified to evaluate the clinical effect 6 months after surgery.

Results

All 5 cases successfully completed the surgery, with the operation time of (68.00±7.11) min, and the intraoperative blood loss of(22.00±3.10) mL. After surgery, the symptoms of lumbago, lower limb numbness, hypoesthesia and other symptoms of 5 patients were significantly improved. The VAS score was 2.20±0.40 2 weeks after surgery;CT three-dimensional reconstruction of lumbar spine 1 month after surgery showed that facet joints and facet processes were well protected.The excellent and good rate of the modified MacNab score was 100%6 months after surgery, with with 4 cases being excellent and 1 case being good. None of the 5 patients had recurrent low back pain,lumbar instability and other complications.

Conclusion

3D robotic digital microscope microchannel surgery is a safe and effective procedure for the treatment of LDH, and good curative effect can be observed in short and medium follow-up.

Key words: Lumbar disc herniation, Microchannel, Three-dimensional robotic digital microscope

Xiaoqiu Zhao, Feng Li, Chuandong Zhao, Yuanqin Liu, Yanda Lin, Tao Xin. Analysis of the curative effect of microchannel surgery on lumbar disc herniation under three-dimensional robotic digital microscope[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2024, 10(04): 243-247.

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References 16

[1]	Amin RM, Andrade NS, Neuman BJ. Lumbar disc herniation[J].Curr Rev Musculoskelet Med, 2017, 10(4): 507 - 516. DOI:10.1007/s12178-017-9441-4.
[2]	Vos T, Flaxman AD, Naghavi M, et al. Years lived with disability(YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the global burden of disease study 2010[J]. Lancet, 2012, 380(9859): 2163-2196. DOI: 10.1016/s0140-6736(12)61729-2.
[3]	Foley KT, Smith MM, Rampersaud YR. Microendoscopic approach to far - lateral lumbar disc herniation[J]. Neurosurg Focus,1999,7(5):e5.DOI:10.3171/foc.1999.7.6.6.
[4]	Greiner-Perth R, Böhm H, El Saghir H. Microscopically assisted percutaneous nucleotomy, an alternative minimally invasive procedure for the operative treatment of lumbar disc herniation:preliminary results[J].Neurosurg Rev,2002,25(4):225-227.DOI:10.1007/s10143-002-0220-2.
[5]	陈春美,蔡刚峰,张伟强,等.椎旁套管入路与后正中入路显微外科治疗腰椎间盘突出症的疗效比较[J].中华神经外科杂志,2014, 30(7): 677-681. DOI: 10.3760/cma.j.issn.1001-2346.2014.07.009.Chen CM, Cai GF, Zhang WQ, et al. Comparison of microinvasive effect between paraspinal tubular retractor system and posterior median approach for treatment of lumbar intervertebral disc herniation[J]. Chin J Neurosurg, 2014, 30(7): 677 - 681. DOI:10.3760/cma.j.issn.1001-2346.2014.07.009.
[6]	DE Divitiis O, D ' Avella E, Denaro L, et al. VITOM^® - 3D:preliminary experience with intradural extramedullary spinal tumors[J]. J Neurosurg Sci, 2022, 66(4): 356-361. DOI: 10.23736/s0390-5616.19.04666-6.
[7]	Baron RB, Lakomkin N, Schupper AJ, et al. Postoperative outcomes following glioblastoma resection using a robot-assisted digital surgical exoscope:a case series[J].J Neurooncol,2020,148(3):519-527.DOI:10.1007/s11060-020-03543-3.
[8]	GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the global burden of disease study 2019[J]. Lancet, 2020, 396(10258): 1204-1222. DOI: 10.1016/s0140-6736(20)30925-9.
[9]	Mayer HM. Discogenic low back pain and degenerative lumbar spinal stenosis-how appropriate is surgical treatment?[J].Schmerz,2001,15(6):484-491.DOI:10.1007/s004820100036.
[10]	Storm PB, Chou D, Tamargo RJ. Surgical management of cervical and lumbosacral radiculopathies: Indications and outcomes[J].Phys Med Rehabil Clin N Am, 2002, 13(3): 735 - 759. DOI:10.1016/s1047-9651(02)00014-1.
[11]	张铭华,董靖,卢旻鹏,等.Wiltse 手术入路和后正中入路经椎间孔腰椎椎体间融合术治疗退变性腰椎滑脱症[J].中华创伤杂志, 2012, 28(7): 624-628. DOI: 10.3760/cma.j.issn.1001-8050.2012.07.014.Zhang MH, Dong J, Lu MP, et al. Wiltse approach and posterior midline approach transforaminal lumbar interbody fusion for degenerative lumbar spondylolisthesis: a comparative study[J].Chin J Trauma, 2012, 28(7): 624 - 628. DOI: 10.3760/cma. j.issn.1001-8050.2012.07.014.
[12]	王硕.脊髓脊柱神经外科的发展与展望[J].中华神经创伤外科电子杂志, 2022, 8(5): 257-260. DOI: 10.3877/cma.j.issn.2095-9141.2022.05.001.Wang S. Development and prospect of spine and spinal cord surgery in neurosurgery[J]. Chin J Neurotrauma Surg (Electronic Edition), 2022, 8(5): 257-260. DOI: 10.3877/cma.j.issn.2095-9141.2022.05.001.
[13]	Cheng J, Wang H, Zheng W, et al. Reoperation after lumbar disc surgery in two hundred and seven patients[J].Int Orthop,2013,37(8):1511-1517.DOI:10.1007/s00264-013-1925-2.
[14]	姚杰,张昌盛,秦利,等.椎板间入路全内窥镜手术与传统显微镜下髓核摘除术治疗L5-S1 椎间盘突出症的疗效及学习曲线分析[J]. 颈腰痛杂志, 2022, 43(2): 159-164. DOI: 10.3969/j.issn.1005-7234.2022.02.003.Yao J, Zhang CS, Qin L, et al. Efficacy and learning curve analysis of interlaminar endoscopic discectomy and traditional microscopic discectomy in the treatment of L5-S1 disc herniation[J]. The Journal of Cervicodynia and Lumbodynia, 2022, 43(2):159-164.DOI:10.3969/j.issn.1005-7234.2022.02.003.
[15]	Clark AJ, Safaee MM, Khan NR, et al. Tubular microdiscectomy:Techniques, complication avoidance, and review of the literature[J]. Neurosurg Focus, 2017, 43(2): E7. DOI: 10.3171/2017.5.Focus17202.
[16]	Montemurro N, Scerrati A, Ricciardi L, et al. The exoscope in neurosurgery: an overview of the current literature of intraoperative use in brain and spine surgery[J].J Clin Med,2021,11(1):223.DOI:10.3390/jcm11010223.

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