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Lesson learned in endoscopic endonasal dens resection for C1–C2 spinal cord decompression
European Spine Journal ( IF 2.6 ) Pub Date : 2023-11-07 , DOI: 10.1007/s00586-023-08001-y
Irene Portonero 1, 2 , Enrico Lo Bue 1, 2 , Federica Penner 1, 2 , Giuseppe Di Perna 3 , Bianca Maria Baldassarre 1, 2, 3 , Raffaele De Marco 1, 2 , Alessandro Pesaresi 1, 2 , Diego Garbossa 1, 2 , Giancarlo Pecorari 4 , Francesco Zenga 1, 2
Affiliation  

Purpose

Endoscopic endonasal approach (EEA) is the safest and most effective technique for odontoidectomy. Nevertheless, this kind of approach is yet not largely widespread. The aim of this study is to share with the scientific community some tips and tricks with our ten-year-old learned experience in endoscopic endonasal odontoidectomy (EEO), which remains a challenging surgical approach.

Material and methods

Our case series consists of twenty-one (10 males, 11 females; age range of 34–84 years) retrospectively analyzed patients with ventral spinal cord compression for non-reducible CVJ malformation, treated with EEA from July 2011 to March 2019.

Results

The results have recently been reported in a previous paper. The only intraoperative complication observed was intraoperative cerebrospinal fluid (CSF) leak (9.5%), without any sign of post-operative CSF leak.

Conclusions

Considering our experience, EEO represents a valid and safe technique to decompress neural cervical structures. Despite its technical complexity, mainly due to the use of endoscope and the challenging surgical area, with this study we encourage the use of EEO displaying our experience-based surgical tips and tricks.



中文翻译:


内镜下鼻内牙髓腔切除术 C1-C2 脊髓减压的经验教训


 目的


内镜鼻内入路(EEA)是齿状突切除术中最安全、最有效的技术。然而,这种方法尚未广泛普及。这项研究的目的是与科学界分享我们十年来在内窥镜鼻内齿状突切除术 (EEO) 方面积累的经验,这仍然是一种具有挑战性的手术方法。

 材料与方法


我们的病例系列由 21 名患者(10 名男性,11 名女性;年龄范围 34-84 岁)组成,回顾性分析了 2011 年 7 月至 2019 年 3 月期间接受 EEA 治疗的因不可复位的 CVJ 畸形而导致腹侧脊髓受压的患者。

 结果


结果最近在之前的一篇论文中报道过。观察到的唯一术中并发症是术中脑脊液(CSF)漏(9.5%),术后没有任何脑脊液漏迹象。

 结论


考虑到我们的经验,EEO 代表了一种有效且安全的颈椎神经结构减压技术。尽管技术复杂,主要是由于内窥镜的使用和具有挑战性的手术区域,但在这项研究中,我们鼓励使用 EEO 来展示我们基于经验的手术技巧和技巧。

更新日期:2023-11-07
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