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Percutaneous transforaminal endoscopic decompression in the treatment of spinal metastases: A case report

机译:经皮经孔椎间孔镜下减压治疗脊柱转移瘤1例

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Rationale: Spinal metastases are always associated with specific pain of back and limbs caused by nerve root compression. Although percutaneous endoscopic lumbar discectomy (PELD) has been widely performed on patients with back and radicular pain originating from lumbar disc herniation, this minimally invasive surgery is rarely used for the treatment of spinal metastases . Patient concerns: A 71-year-old woman with colon cancer and a known L3 vertebral body metastasis presented with significant progressive pain of low back and limbs. Diagnoses: Magnetic resonance imaging (MRI) showed the L3 vertebral body had been involved by osteolytic vertebral metastasis, which extended into spinal canal and compressed the dural sac and nerve root . Interventions: The patient was treated with percutaneous transforaminal endoscopic decompression and palliative resection of metastases was performed twice on both sides, respectively. After the minimally invasive procedure, the decompression of the dural sac and nerve root was ideal. Outcomes: No complications during the procedure were reported. The minimally invasive surgery resulted in prompt and permanent pain relief until the patient died 6 months later. Lessons: Percutaneous transforaminal endoscopic decompression could be an appropriate treatment option for the patients who suffer neurologic deficits that result from the spinal metastases .
机译:理由:脊柱转移瘤通常与神经根受压引起的背部和四肢特定疼痛有关。尽管经皮内镜下腰椎间盘切除术(PELD)已广泛用于腰椎间盘突出症引起的背部和神经根疼痛的患者,但这种微创手术很少用于治疗脊柱转移瘤。患者担忧:一名71岁的患有结肠癌和已知的L3椎体转移的妇女表现为下背部和四肢明显疼痛。诊断:磁共振成像(MRI)显示L3椎体参与了溶骨性椎骨转移,其扩散至椎管并压缩了硬膜囊和神经根。干预措施:对患者行经皮经椎间孔镜下内镜减压术,并在两侧分别姑息性切除转移灶两次。经过微创手术后,理想的是硬膜囊和神经根减压。结果:没有报道手术过程中的并发症。微创手术可迅速且永久缓解疼痛,直到患者在6个月后死亡。经验教训:经皮椎间孔镜下内镜减压术可能是因脊柱转移瘤而导致神经功能缺损的患者的合适治疗选择。

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