Phase I 270° single-incision percutaneous spinal endoscopy for decompression treatment of thoracic spinal stenosis

Abstract This study aimed to explore the feasibility of Phase I percutaneous spinal endoscopy with a 270° single incision in the ventral and dorsal dura mater for decompression treatment of thoracic spinal stenosis (TSS). Phase I percutaneous spinal endoscopy with a two-path (posterior and posterola...

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Main Authors: Yuefei Li, Jingwei Bi, Zhaozhong Sun, Jiabin Ren, Xin Liu, Ning Sun, Jianye Wang, Rui Li
Format: Article
Language:English
Published: Nature Portfolio 2022-06-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-022-13666-4
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author Yuefei Li
Jingwei Bi
Zhaozhong Sun
Jiabin Ren
Xin Liu
Ning Sun
Jianye Wang
Rui Li
author_facet Yuefei Li
Jingwei Bi
Zhaozhong Sun
Jiabin Ren
Xin Liu
Ning Sun
Jianye Wang
Rui Li
author_sort Yuefei Li
collection DOAJ
description Abstract This study aimed to explore the feasibility of Phase I percutaneous spinal endoscopy with a 270° single incision in the ventral and dorsal dura mater for decompression treatment of thoracic spinal stenosis (TSS). Phase I percutaneous spinal endoscopy with a two-path (posterior and posterolateral approaches) single incision with a 270° decompression was performed in four cases of TSS with compression in the ventral and dorsal dura mater. The affected intervertebral space was located during the surgery, and the ossified ligamentum flavum in the ventral and dorsal dura mater was removed via laminectomy, which formed a decompression space in the thoracic cord. Next, posterolateral transforaminal expansion and plasty were performed to remove the ventral intervertebral disk. The visual analogue scale (VAS) score, thoracic spinal cord function score of the Japanese Orthopaedic Association (JOA) (11-point method), and Oswestry Disability Index (ODI) scores were used to evaluate the clinical efficacy. No dura mater or thoracic nerve injury occurred during the surgery. The symptoms of weakness in the lower extremities improved after the surgery. The postoperative magnetic resonance imaging and computed tomography examinations showed compression removal and dura mater bulging. The postoperative VAS, JOA, and ODI scores improved compared with the preoperative scores. Two surgical trajectories, posterior and posterolateral approaches, were established by a single incision using thoracic spinal canal decompression with Phase I 270° single-incision percutaneous spinal endoscopy. The posterior approach was performed mainly by translaminar unilateral fenestration and bilateral decompression in the ventral and dorsal dura mater, whereas the posterolateral approach was performed by decompression in the ventral dura mater to the midline of the vertebrae. This surgical method could be applied as a safe and feasible minimally invasive treatment for TSS with compression on both the ventral and dorsal dura mater.
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spelling doaj.art-3e34bb70baf94dbb9519226cc374ff172022-12-22T00:18:40ZengNature PortfolioScientific Reports2045-23222022-06-011211610.1038/s41598-022-13666-4Phase I 270° single-incision percutaneous spinal endoscopy for decompression treatment of thoracic spinal stenosisYuefei Li0Jingwei Bi1Zhaozhong Sun2Jiabin Ren3Xin Liu4Ning Sun5Jianye Wang6Rui Li7Department of Spine, Binzhou Medical University HospitalDepartment of Spine, Binzhou Medical University HospitalDepartment of Spine, Binzhou Medical University HospitalDepartment of Spine, Binzhou Medical University HospitalDepartment of Spine, Binzhou Medical University HospitalDepartment of Spine, Binzhou Medical University HospitalDepartment of Spine, Binzhou Medical University HospitalDepartment of Spine, Binzhou Medical University HospitalAbstract This study aimed to explore the feasibility of Phase I percutaneous spinal endoscopy with a 270° single incision in the ventral and dorsal dura mater for decompression treatment of thoracic spinal stenosis (TSS). Phase I percutaneous spinal endoscopy with a two-path (posterior and posterolateral approaches) single incision with a 270° decompression was performed in four cases of TSS with compression in the ventral and dorsal dura mater. The affected intervertebral space was located during the surgery, and the ossified ligamentum flavum in the ventral and dorsal dura mater was removed via laminectomy, which formed a decompression space in the thoracic cord. Next, posterolateral transforaminal expansion and plasty were performed to remove the ventral intervertebral disk. The visual analogue scale (VAS) score, thoracic spinal cord function score of the Japanese Orthopaedic Association (JOA) (11-point method), and Oswestry Disability Index (ODI) scores were used to evaluate the clinical efficacy. No dura mater or thoracic nerve injury occurred during the surgery. The symptoms of weakness in the lower extremities improved after the surgery. The postoperative magnetic resonance imaging and computed tomography examinations showed compression removal and dura mater bulging. The postoperative VAS, JOA, and ODI scores improved compared with the preoperative scores. Two surgical trajectories, posterior and posterolateral approaches, were established by a single incision using thoracic spinal canal decompression with Phase I 270° single-incision percutaneous spinal endoscopy. The posterior approach was performed mainly by translaminar unilateral fenestration and bilateral decompression in the ventral and dorsal dura mater, whereas the posterolateral approach was performed by decompression in the ventral dura mater to the midline of the vertebrae. This surgical method could be applied as a safe and feasible minimally invasive treatment for TSS with compression on both the ventral and dorsal dura mater.https://doi.org/10.1038/s41598-022-13666-4
spellingShingle Yuefei Li
Jingwei Bi
Zhaozhong Sun
Jiabin Ren
Xin Liu
Ning Sun
Jianye Wang
Rui Li
Phase I 270° single-incision percutaneous spinal endoscopy for decompression treatment of thoracic spinal stenosis
Scientific Reports
title Phase I 270° single-incision percutaneous spinal endoscopy for decompression treatment of thoracic spinal stenosis
title_full Phase I 270° single-incision percutaneous spinal endoscopy for decompression treatment of thoracic spinal stenosis
title_fullStr Phase I 270° single-incision percutaneous spinal endoscopy for decompression treatment of thoracic spinal stenosis
title_full_unstemmed Phase I 270° single-incision percutaneous spinal endoscopy for decompression treatment of thoracic spinal stenosis
title_short Phase I 270° single-incision percutaneous spinal endoscopy for decompression treatment of thoracic spinal stenosis
title_sort phase i 270° single incision percutaneous spinal endoscopy for decompression treatment of thoracic spinal stenosis
url https://doi.org/10.1038/s41598-022-13666-4
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