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논문 기본 정보

자료유형
학술저널
저자정보
Mazda Farshad (University Spine Center Zurich, Balgrist University Hospital, University of Zurich) Alexandra Stauffer (University Spine Center Zurich, Balgrist University Hospital, University of Zurich) Carl Moritz Zipser (Spinal Cord Injury Center and Department of Neurology and Neurophysiology, Balgrist University Hospital) Najmeh Kheram (Spinal Cord Injury Center and Department of Neurology and Neurophysiology, Balgrist University Hospital) José Miguel Spirig (University Spine Center Zurich, Balgrist University Hospital, University of Zurich) Jonas Widmer (Spine Biomechanics, Department of Orthopaedics, Balgrist University Hospital) Vincent Hagel (University Spine Center Zurich, Balgrist University Hospital, University of Zurich) Jana Felicitas Schader (University Spine Center Zurich, Balgrist University Hospital, University of Zurich)
저널정보
대한척추신경외과학회 Neurospine Neurospine Vol.21 No.3
발행연도
2024.9
수록면
745 - 752 (8page)
DOI
10.14245/ns.2448350.175

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초록· 키워드

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Objective: Endoscopic spine surgery is an emerging technique of minimally invasive spine surgery. However, headache, seizure, and autonomic dysreflexia are possible irrigation-related complications following full-endoscopic lumbar discectomy (FELD). Pressure elevation through fluid irrigation may contribute to these adverse events. A validated experimental model to investigate parameters for guideline definition is lacking. This study aimed to create an experimental setting for FELD with pressure assessments to prove the concept of repeatable and sensitive measurement of intracranial, intra- and epidural pressure during spine endoscopy. Methods: To measure intradural pressure, catheters were introduced through a sacral ap proach and advanced to lumbar, thoracic, and cervical levels in human cadavers. Similarly, lumbar epidural and intracranial probes were placed. The dural sac was filled with Ringer solution to a physiologic pressure of 15 cmH2O. Lumbar endoscopy was performed on 3 human cadavers at the L3–4 level. Pressure changes were measured continuously at all sites and the effect of backflow-occlusion was monitored. Results: Reproducibility of the experimental model was validated with catheters at the correct locations and stable compartmental pressure baselines at all levels for 3 specimens (mean ± standard deviation: 1.3 ± 2.9 mmHg, 9.0 ± 2.0 mmHg, 6.0 ± 1.2 mmHg, respectively). Pressure increase could be detected sensitively by closing the system with backflow-occlusion. Conclusion: An experimental setup for feasible, repeatable, and precise pressure measurement during FELD in a human cadaveric setup has been developed. This allows investigation of the effect of endoscopic techniques and pump pressures on intra-, epidural and intracranial pressure and enables ranges of safe pump pressures per clinical situation.

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