小关节切除术
面(心理学)
减压
医学
小关节
侧隐窝
腰椎管狭窄症
神经根
腰椎
外科
孔切开术
椎管狭窄
解剖
椎板切除术
脊髓
人格
五大性格特征
精神科
社会心理学
心理学
作者
Yasushi Fujiwara,Hideki Manabe,Tadayoshi Sumida,Bunichiro Izumi,Kazuyoshi Nakanishi,Nobuhiro Tanaka,Nobuo Adachi
出处
期刊:Clinical spine surgery
[Ovid Technologies (Wolters Kluwer)]
日期:2017-06-01
卷期号:30 (5): 197-203
被引量:10
标识
DOI:10.1097/bsd.0000000000000487
摘要
Posterior decompression surgery which enlarges the spinal canal in cases with lumbar spinal stenosis is the most fundamental technique in spine surgery, but controversy still remains for the exact technique. Because nerve roots run under the ventral side on the superior articular process (SAP), achieving both facet joint preservation and nerve root decompression is problematic. In conventional laminotomies or laminectomies, medial facetectomies are performed to decompress the nerve root, but it is ideal to preserve the facet joints completely for preserving joint stability. We handle this problem with an original decompression technique, called "semicircumferential decompression." The main features of this procedure are an en bloc flavectomy and total preservation of facet joints. The procedure is performed under the microscope with a midline approach. The flavum is detached from the ventral surface of the SAP using a currete without disturbing the SAP. The facet joints are preserved completely. The advantage of an en bloc flavectomy is that we can remove the flavum attachment to the ventral surface of SAP totally without a medial facetectomy. Since 1991, we have performed this technique in more than 5000 cases. In this paper, we will explain the tips, pitfalls, and advantages of this technique.
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