Full-endoscopic interlaminar strategy for nerve root decompression of sacral metastatic tumor.
World Neurosurg. 2018 Jan 17;:
Authors: Tsai SH, Wu HH, Cheng CY, Chen CM
BACKGROUND: Endoscopic surgical procedure has been efficiently utilized within the therapy of degenerative spinal illness, however few research have assessed its use in treating sacral metastasis. Herein, a profitable full endoscopic interlaminar strategy for sacral nerve root decompression of a sacral metastatic tumor was introduced.
CASE DESCRIPTION: An 80-year-old man with historical past of hepatocellular carcinoma suffered from buttock ache with radiation to the suitable decrease leg for one week. There was additionally decreased muscle energy of the suitable decrease extremity. The lumbosacral magnetic resonance imaging (MRI) scan revealed metastasis of the sacral backbone and proper iliac bone with S1 exiting nerve root compression. S1 nerve root decompression by way of the full-endoscopic interlaminar strategy below native anesthesia was carried out. Underneath the steerage of fluorescence, a working sleeve with a beveled opening was positioned within the interlaminar area of L5-S1. We entered the sacral canal and recognized the S1 exiting nerve root. A laminotomy was carried out from the inner fringe of the suitable sacral laminae towards the lateral recess. Through the decompression of the nerve root, the buttock and leg ache improved step by step. After the operation, there was nearly full decision of leg ache and the affected person recovered the flexibility to stroll. The visible analogue scales for ache decreased from eight to 2 after three months’ follow-up.
CONCLUSIONS: For sufferers with sacral metastasis, with out spinal instability or problem mendacity in inclined place below native anesthesia, the full-endoscopic interlaminar strategy for nerve root decompression of sacral metastasis could also be an obtainable technique.
PMID: 29355803 [PubMed – as supplied by publisher]