지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2020.1
- 수록면
- 790 - 800 (11page)
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초록· 키워드
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Study Design: Here we perform a retrospective analysis regarding an incidental dural tear (IDT) during biportal endoscopic spinal surgery (BESS).Purpose: This study investigates the causes of IDT specifically related to technical procedures of BESS with the aim of lowering its risk during training.Overview of Literature: The incidence of dural tear is reported 0.5%–18% in open spinal surgery and 1.7%–4.3% during endoscopic spinal surgery. Because conversion to open surgery for direct repair could become necessary during endoscopic spinal surgery, prevention of this complication is essential.Methods: We have retrospectively studied IDTs by four surgeons during 1 or 2 years after starting BESS for lumbar degenerative diseases and analyzed the locations, sizes, and specific endoscopic conditions specific to each.Results: Twenty-five cases (1.6%) of IDTs among 1,551 cases of BESS occurred; 13 cases (52%) of these were within the first 6 months. The locations were dorsal midline in 12 cases, ipsilateral side in 11 cases, and contralateral side in two cases. The tear sizes were <10 mm in 20 cases and ≥10 mm in five cases. IDT commonly occurred due to injury of central dural folding during flavectomy under turbid surgical fields due to small bleeds under water. Twenty cases with IDTs of <10 mm were treated well with the patch technique. Among five cases of ≥10 mm, three underwent open repair within a few days, and two of these which failed to conservative management required a delayed revision operation due to pseudomeningocele. No cases progressed to surgical site infection or infectious spondylitis.Conclusions: IDTs of <10 mm can be successfully treated with the patch technique. To prevent IDT during the early learning period, maintaining clear visibility by securing fluent saline outflow and meticulous hemostasis of small bleeding from exposed cancellous bone and epidural vessels is essential with caution not to injure the central dural folding during midline flavectomy.
목차
등록된 정보가 없습니다.
참고문헌 (29)
참고문헌 신청
Min WK / 2019 / Clinical and radiological outcomes between biportal endoscopic decompression and microscopic decompression in lumbar spinal stenosis / J Orthop Sci
Ju-Eun Kim / 2019 / Biportal Endoscopic Spinal Surgery for Lumbar Spinal Stenosis / Asian Spine Journal 13(2):334~342
Ju-Eun Kim / 2018 / Clinical and Radiological Outcomes of Unilateral Biportal Endoscopic Decompression by 30° Arthroscopy in Lumbar Spinal Stenosis: Minimum 2-Year Follow-up / Clinics in Orthopedic Surgery 10(3):328~336
최대정 / 2018 / Biportal Endoscopic Spine Surgery for Various Foraminal Lesions at the Lumbosacral Lesion / Asian Spine Journal 12(3):569~573
김주은 / 2018 / Biportal Endoscopic Transforaminal Lumbar Interbody Fusion with Arthroscopy / Clinics in Orthopedic Surgery 10(2):248~252
Ju-Eun Kim / 2019 / Biportal Endoscopic Spinal Surgery for Lumbar Spinal Stenosis / Asian Spine Journal 13(2):334~342
Ju-Eun Kim / 2018 / Clinical and Radiological Outcomes of Unilateral Biportal Endoscopic Decompression by 30° Arthroscopy in Lumbar Spinal Stenosis: Minimum 2-Year Follow-up / Clinics in Orthopedic Surgery 10(3):328~336
최대정 / 2018 / Biportal Endoscopic Spine Surgery for Various Foraminal Lesions at the Lumbosacral Lesion / Asian Spine Journal 12(3):569~573
김주은 / 2018 / Biportal Endoscopic Transforaminal Lumbar Interbody Fusion with Arthroscopy / Clinics in Orthopedic Surgery 10(2):248~252
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