Lumbar interbody fusion is essential for treating degenerative lumbar diseases.The disadvantages of open surgery have led to the evolution of minimally invasive spine surgery,including endoscopic techniques such as un...Lumbar interbody fusion is essential for treating degenerative lumbar diseases.The disadvantages of open surgery have led to the evolution of minimally invasive spine surgery,including endoscopic techniques such as unilateral biportal endoscopy(UBE).Leveraging arthroscopic principles,UBE offers superior visualization and flexibility and expands from decompression to fusion(UBE fusion).However,achieving robust UBE fusion presents challenges,such as suboptimal arthrodesis rates and implant-related complications,requiring more than surgical skill alone.Optimizing UBE fusion critically depends on the effective integration of advanced biomaterials with the surgical technique.This minireview assessed recent advances in UBE,focusing on the development of novel biomaterials,such as functionalized porous,expandable,or double-cage designs,to improve bone regeneration outcomes.These advancements address challenges,like washout of bone graft material and biologics,and utilize growth factors,such as recombinant human bone morphogenetic proteins,while exploring pathway modulation to improve outcomes.We also evaluated clinical optimization strategies involving technical refinements,fluid and hemostasis control,key complication mitigation especially concerning dural tears and hematomas,and technologies such as navigation and robotics.While UBE shows promise particularly for early recovery,its long-term success hinges on these biotechnological advancements.High-quality evidence,especially from randomized controlled trials and longterm studies,is needed to validate integrated strategies and define the optimal role of UBE fusion.展开更多
BACKGROUND Uniportal full-endoscopy(UFE)technique has been continuously developed and applied for treating lumbar spinal stenosis.However,achieving effective decompression outcome of using the UFE technique remains te...BACKGROUND Uniportal full-endoscopy(UFE)technique has been continuously developed and applied for treating lumbar spinal stenosis.However,achieving effective decompression outcome of using the UFE technique remains technically demanding and uncertain.Previously,we have proposed the biportal full-endoscopy(BFE)technique to integrate the respective advantages of both UFE and unilateral biportal endoscopy technique.There is limited published data on the comparison of clinical outcomes between biportal and UFE techniques in lumbar spinal stenosis with bilateral symptoms.AIM To contrast the clinical outcomes between biportal and UFE techniques for treating lumbar spinal stenosis with bilateral symptoms.METHODS This study retrospectively examined 100 patients diagnosed with lumbar spinal stenosis and bilateral symptoms.Among them,52 cases were part of group A(BFE technique group),and 48 cases belonged to group B(UFE technique group).The visual analogue scale(VAS),Oswestry Disability Index(ODI),and modified Macnab criteria were used to evaluate the clinical outcomes.RESULTS Group A had significantly shorter operation time than group B.Both groups experienced substantial relief in lower back and lower extremity pain on the severe side at postoperative 3 days,3 months,and 12 months.Group A had notably lower VAS scores for mild side lower extremity pain at postoperative 3 months and 12 months compared to group B.Group A's ODI scores were significantly lower at postoperative 3 months and 12 months,whereas group B's scores did not significantly differ from preoperative values.Group A's ODI scores were significantly lower than group B's at postoperative 3 months and 12 months.Group A had a significantly higher excellent and good response rate(94.23%)compared to group B(81.25%)at postoperative 12 months based on the modified Macnab scale outcomes.CONCLUSION The BFE technique offers multiple benefits,including reduced trauma and quicker recovery as a minimally invasive surgery,and enhanced decompression efficiency over the UFE technique when treating lumbar spinal stenosis with bilateral symptoms.展开更多
Unintended dural tear(DT)is not an infrequent complication of biportal percutaneous endoscopic spinal surgery(BESS).DT manifests in neurological deficits,including seizure,headache,and intracranial hemorrhage.Meanwhil...Unintended dural tear(DT)is not an infrequent complication of biportal percutaneous endoscopic spinal surgery(BESS).DT manifests in neurological deficits,including seizure,headache,and intracranial hemorrhage.Meanwhile,DT may be a risk of emergence agitation(EA)after BESS,which has not yet been reported.We presented a case of a 55-year-old man with L5-S1 intervertebral disc herniation receiving BESS under general anesthesia.A DT about 3-4 mm occurred during the operation,and was repaired immediately.The patient presented EA shouting for a headache after the surgery in post anesthesia care unit(PACU).Sedative agents(midazolam,propofol and dexmedetomidine)were used,only continuously infusion of dexmedetomidine for about 4 h successfully improved EA in PACU.He had no neurologic deficits in following 3 months.This case report highlights the risk of EA when a DT occurs during BESS.Adequate sedation in early phase is critical to resolve the mass effect caused by EA.展开更多
BACKGROUND Unilateral biportal endoscopic(UBE)surgery has developed rapidly during the past decade.Continuous epidural space irrigation is generally considered the principal reason for cerebral complications following...BACKGROUND Unilateral biportal endoscopic(UBE)surgery has developed rapidly during the past decade.Continuous epidural space irrigation is generally considered the principal reason for cerebral complications following UBE surgery.We present a case of mental symptoms during the general anesthesia awakening period due to pneumocephalus.CASE SUMMARY A 70-year-old woman with lumbar disc herniation underwent UBE surgery stably under general anesthesia.Uncontrollable hypertension occurred immediately after transfer to the postoperative care unit,accompanied by increased heart rate and tachypnea.During the recovery process,the patient responded to external stimuli but was confused and unable to complete command actions.Neck stiff-ness and significantly increased muscle strength on the left side indicated the presence of de-cerebrate rigidity.An urgent brain computed tomography scan showed pneumocephalus compressing the brainstem.After receiving analgesia and sedation treatment,the patient was conscious three hours later and recovered rapidly.She was discharged on the fifth postoperative day and followed up for 3 months with no surgical or brain complications.CONCLUSION Cerebral complications emerging during the general anesthesia awakening period following UBE surgery are not entirely due to increased intracranial pressure.Pneumocephalus induced by dural injury may also be a potential cause.展开更多
BACKGROUND This reported procedure combines the orthopedic surgical robot with the unilateral biportal endoscopy-lumbar interbody fusion(UBE-LIF),utilizing the UBE's wide viewing field and operating space to perfo...BACKGROUND This reported procedure combines the orthopedic surgical robot with the unilateral biportal endoscopy-lumbar interbody fusion(UBE-LIF),utilizing the UBE's wide viewing field and operating space to perform minimally invasive decompressive fusion of the lesioned segment,and the orthopedic surgical robot's intelligence and precision to perform percutaneous pedicle screw placement.The advancement of this procedure lies in the superposition of advantages and offsetting disadvantages of the two new technologies,and the maximum effect of treatment is achieved with maximum minimization of invasiveness and precision under the monitoring of imaging instruments to maximize the benefit of patients,and this review reports a case of multiple-segment lumbar decompression and fusion surgery for lumbar disc herniation via robot-assisted UBE for reference.CASE SUMMARY A 44-year-old patient presented to our hospital.Combining various clinical data,we diagnosed the patient with lumbar disc herniation with radiculopathy,lumbar spondylolisthesis,and lumbar spinal stenosis.We developed a surgical plan of"UBE decompression+UBE-LIF+orthopedic surgery robot-assisted percutaneous pedicle screw implantation for internal fixation".The results were satisfactory.CONCLUSION We present an extremely rare case of multiple-segment lumbar decompression and fusion surgery for lumbar disc herniation via robot-assisted UBE and achieved good results.Therefore,the technique is worthy of clinical promotion.展开更多
Objective: Explore the feasibility and clinical efficacy of using unilateral biportal endoscopy for the treatment of Type II/III lumbar brucellar spondylitis. Methods: A retrospective study of the clinical data of 20 ...Objective: Explore the feasibility and clinical efficacy of using unilateral biportal endoscopy for the treatment of Type II/III lumbar brucellar spondylitis. Methods: A retrospective study of the clinical data of 20 patients with Type II/III lumbar brucellar spondylitis admitted to the First Affiliated Hospital of Hebei North University from January 2020 to May 2022, including 15 males and 5 females, aged 41 - 60 years old, average age (48.11 ± 7.28) years old. After admission, the patient can isolate brucella through metagenomic Next-Generation Sequencing (mNGS), meeting the tertiary diagnostic criteria. Preoperative conventional drug treatment, unilateral biportal endoscopic minimally invasive surgery was performed when nutrition was improved, perioperative control of various indexes was stable, and erythrocyte sedimentation was declining. It was completed under an endoscope. The lesion was cleared, spinal nerve compression was relieved, interbody fusion was performed, and the spine was fixed by a percutaneous pedicle screw. Erythrocyte Sedimentation Rate (ESR), C-Reactive Protein (CRP), Visual Analogue Scale (VAS), Japanese Orthopedic Association (JOA) score and Oswestry Disability Index (ODI) were analyzed at 1 month, 3 months, 6 months and the last follow-up. At the final follow-up of all patients, the clinical efficacy criteria and the Bridwell grading criteria were used to evaluate the recovery and intervertebral bone graft fusion, respectively. Results: All patients’ lower back and leg pain was relieved the next day after surgery. At a follow-up of one month after surgery, both systemic and local symptoms significantly improved. At the last follow-up, clinical symptoms disappeared and there was no tenderness or percussion pain in the local area. With the passage of time, 1 month, 3 months, 6 months after the operation, and the last follow-up are all evaluation indicators compared with those before the operation. No matter VAS, JOA, ODI score, or ESR, CRP is significantly improved compared with preoperative (P All 20 cases in this group reached the BS clinical cure standard, and the excellent rate of intervertebral bone graft fusion was 95%. Conclusion: On the basis of .展开更多
Recent epidemiological data have revealed an increasing incidence of atlantoaxial (C1–C2) stenosis. In this study, we review the merits and limitations of traditional surgical techniques for the decompression and exc...Recent epidemiological data have revealed an increasing incidence of atlantoaxial (C1–C2) stenosis. In this study, we review the merits and limitations of traditional surgical techniques for the decompression and excision of atlantoaxial stenosis, and introduce a novel biportal endoscopy method. A retrospective analysis was conducted on 1562 cases extracted from 19 articles. These patients, diagnosed with cervical spondylotic myelopathy or cervical spondylosis with various etiologies, underwent surgery using either a posterior biportal endoscopic approach for cervical discectomy or cervical canal decompression. Additionally, we present two cases of atlantoaxial cervical spondylosis treated using the biportal endoscopy approach, yielding positive clinical and radiological outcomes. Common complications associated with spinal endoscopy surgery include dura injury, nerve root injury, hematoma, and recurrence of the condition. While endoscopic cervical spinal surgery shows promising results in terms of efficacy and safety, further detailed assessments of potential complications are necessary.展开更多
BACKGROUND This is a retrospective study on endoscopic treatment of cervical spinal radiculopathy(CSR)conducted at a single academic institution.Conventional full-spine endoscopy is performed in a single portal which ...BACKGROUND This is a retrospective study on endoscopic treatment of cervical spinal radiculopathy(CSR)conducted at a single academic institution.Conventional full-spine endoscopy is performed in a single portal which has certain limitations of high technical requirements,steep learning curve,and narrow indications.Although unilateral biportal endoscopy(UBE)technique has a gentle learning curve and is gradually applied to treat CSR,all procedures were performed in the uniportal working channel that potentially increase the surgical risk and time in the treatment of complex cases.It is worthy to delve novel technique for more working channels in the treatment of complex CSR.AIM To propose a hybrid technique(HT)that utilizes spine endoscopy in UBE to treatment of CSR.METHODS A total of 81 patients with single-segment CSR who underwent uniportal endoscopic surgery(UES),UBE,or HT at a single institution between September 2019 and August 2021 were retrospectively studied.Perioperative patient data were compared between the groups.The pre-operative and post-operative images were compared to confirm adequate decompression of the nerve root canal.Patients'visual analogue scale(VAS)scores and neck disability index(NDI)were recorded before surgery,and three days,three months and six months after surgery.RESULTS The UBE and HT groups had a significantly shorter operation duration than the UES group.Data for bleeding and length of hospital stay were significantly higher in the UBE group than in the UES and HT groups.The hospitalization cost was lowest in the UES group and highest in the HT group.Soft tissue edema reaction bands on postoperative day 3 were larger in the UBE and HT groups than in the UES group.Post-operative VAS and NDI scores were significantly lower in all three groups than the pre-operative levels.On post-operative day 3,the VAS score for neck pain was significantly higher in the UBE and HT groups than that in the UES group.However,there were no significant differences in the VAS scores for arm pain or NDI between the three groups.The post-operative 3-month and 6-month neck pain VAS,arm pain VAS,NDI,and modified Macnab success rates did not differ statistically between the three groups.CONCLUSION The HT for CSR treatment has the advantage of double working channels to facilitate decompression and hemostasis,improving the surgical efficiency and clinical outcomes of CSR.展开更多
基金Supported by Joint Traditional Chinese Medicine Science and Technology Projects of National Demonstration Zones for Comprehensive Traditional Chinese Medicine,No.GZY-KJS-SD-2023-031.
文摘Lumbar interbody fusion is essential for treating degenerative lumbar diseases.The disadvantages of open surgery have led to the evolution of minimally invasive spine surgery,including endoscopic techniques such as unilateral biportal endoscopy(UBE).Leveraging arthroscopic principles,UBE offers superior visualization and flexibility and expands from decompression to fusion(UBE fusion).However,achieving robust UBE fusion presents challenges,such as suboptimal arthrodesis rates and implant-related complications,requiring more than surgical skill alone.Optimizing UBE fusion critically depends on the effective integration of advanced biomaterials with the surgical technique.This minireview assessed recent advances in UBE,focusing on the development of novel biomaterials,such as functionalized porous,expandable,or double-cage designs,to improve bone regeneration outcomes.These advancements address challenges,like washout of bone graft material and biologics,and utilize growth factors,such as recombinant human bone morphogenetic proteins,while exploring pathway modulation to improve outcomes.We also evaluated clinical optimization strategies involving technical refinements,fluid and hemostasis control,key complication mitigation especially concerning dural tears and hematomas,and technologies such as navigation and robotics.While UBE shows promise particularly for early recovery,its long-term success hinges on these biotechnological advancements.High-quality evidence,especially from randomized controlled trials and longterm studies,is needed to validate integrated strategies and define the optimal role of UBE fusion.
基金Supported by National Natural Science Foundation of China,No.82202694Clinical Research Innovation Plan of Shanghai General Hospital,No.CTCCR-2021C10.
文摘BACKGROUND Uniportal full-endoscopy(UFE)technique has been continuously developed and applied for treating lumbar spinal stenosis.However,achieving effective decompression outcome of using the UFE technique remains technically demanding and uncertain.Previously,we have proposed the biportal full-endoscopy(BFE)technique to integrate the respective advantages of both UFE and unilateral biportal endoscopy technique.There is limited published data on the comparison of clinical outcomes between biportal and UFE techniques in lumbar spinal stenosis with bilateral symptoms.AIM To contrast the clinical outcomes between biportal and UFE techniques for treating lumbar spinal stenosis with bilateral symptoms.METHODS This study retrospectively examined 100 patients diagnosed with lumbar spinal stenosis and bilateral symptoms.Among them,52 cases were part of group A(BFE technique group),and 48 cases belonged to group B(UFE technique group).The visual analogue scale(VAS),Oswestry Disability Index(ODI),and modified Macnab criteria were used to evaluate the clinical outcomes.RESULTS Group A had significantly shorter operation time than group B.Both groups experienced substantial relief in lower back and lower extremity pain on the severe side at postoperative 3 days,3 months,and 12 months.Group A had notably lower VAS scores for mild side lower extremity pain at postoperative 3 months and 12 months compared to group B.Group A's ODI scores were significantly lower at postoperative 3 months and 12 months,whereas group B's scores did not significantly differ from preoperative values.Group A's ODI scores were significantly lower than group B's at postoperative 3 months and 12 months.Group A had a significantly higher excellent and good response rate(94.23%)compared to group B(81.25%)at postoperative 12 months based on the modified Macnab scale outcomes.CONCLUSION The BFE technique offers multiple benefits,including reduced trauma and quicker recovery as a minimally invasive surgery,and enhanced decompression efficiency over the UFE technique when treating lumbar spinal stenosis with bilateral symptoms.
文摘Unintended dural tear(DT)is not an infrequent complication of biportal percutaneous endoscopic spinal surgery(BESS).DT manifests in neurological deficits,including seizure,headache,and intracranial hemorrhage.Meanwhile,DT may be a risk of emergence agitation(EA)after BESS,which has not yet been reported.We presented a case of a 55-year-old man with L5-S1 intervertebral disc herniation receiving BESS under general anesthesia.A DT about 3-4 mm occurred during the operation,and was repaired immediately.The patient presented EA shouting for a headache after the surgery in post anesthesia care unit(PACU).Sedative agents(midazolam,propofol and dexmedetomidine)were used,only continuously infusion of dexmedetomidine for about 4 h successfully improved EA in PACU.He had no neurologic deficits in following 3 months.This case report highlights the risk of EA when a DT occurs during BESS.Adequate sedation in early phase is critical to resolve the mass effect caused by EA.
文摘BACKGROUND Unilateral biportal endoscopic(UBE)surgery has developed rapidly during the past decade.Continuous epidural space irrigation is generally considered the principal reason for cerebral complications following UBE surgery.We present a case of mental symptoms during the general anesthesia awakening period due to pneumocephalus.CASE SUMMARY A 70-year-old woman with lumbar disc herniation underwent UBE surgery stably under general anesthesia.Uncontrollable hypertension occurred immediately after transfer to the postoperative care unit,accompanied by increased heart rate and tachypnea.During the recovery process,the patient responded to external stimuli but was confused and unable to complete command actions.Neck stiff-ness and significantly increased muscle strength on the left side indicated the presence of de-cerebrate rigidity.An urgent brain computed tomography scan showed pneumocephalus compressing the brainstem.After receiving analgesia and sedation treatment,the patient was conscious three hours later and recovered rapidly.She was discharged on the fifth postoperative day and followed up for 3 months with no surgical or brain complications.CONCLUSION Cerebral complications emerging during the general anesthesia awakening period following UBE surgery are not entirely due to increased intracranial pressure.Pneumocephalus induced by dural injury may also be a potential cause.
基金Supported by National Natural Science Foundation of China(Regional Program),No.82060879,No.82360947Gansu Province Key Talent Project,No.2024-4+2 种基金Natural Science Foundation of Gansu Province,No.20JR10RA356Gansu Provincial Joint Research Fund,No.23JRRA1534National Administration of Traditional Chinese Medicine High Level Key Discipline Construction Project of Traditional Chinese Medicine(Traditional Chinese Orthopedics and Traumatology Science),No.203.
文摘BACKGROUND This reported procedure combines the orthopedic surgical robot with the unilateral biportal endoscopy-lumbar interbody fusion(UBE-LIF),utilizing the UBE's wide viewing field and operating space to perform minimally invasive decompressive fusion of the lesioned segment,and the orthopedic surgical robot's intelligence and precision to perform percutaneous pedicle screw placement.The advancement of this procedure lies in the superposition of advantages and offsetting disadvantages of the two new technologies,and the maximum effect of treatment is achieved with maximum minimization of invasiveness and precision under the monitoring of imaging instruments to maximize the benefit of patients,and this review reports a case of multiple-segment lumbar decompression and fusion surgery for lumbar disc herniation via robot-assisted UBE for reference.CASE SUMMARY A 44-year-old patient presented to our hospital.Combining various clinical data,we diagnosed the patient with lumbar disc herniation with radiculopathy,lumbar spondylolisthesis,and lumbar spinal stenosis.We developed a surgical plan of"UBE decompression+UBE-LIF+orthopedic surgery robot-assisted percutaneous pedicle screw implantation for internal fixation".The results were satisfactory.CONCLUSION We present an extremely rare case of multiple-segment lumbar decompression and fusion surgery for lumbar disc herniation via robot-assisted UBE and achieved good results.Therefore,the technique is worthy of clinical promotion.
文摘Objective: Explore the feasibility and clinical efficacy of using unilateral biportal endoscopy for the treatment of Type II/III lumbar brucellar spondylitis. Methods: A retrospective study of the clinical data of 20 patients with Type II/III lumbar brucellar spondylitis admitted to the First Affiliated Hospital of Hebei North University from January 2020 to May 2022, including 15 males and 5 females, aged 41 - 60 years old, average age (48.11 ± 7.28) years old. After admission, the patient can isolate brucella through metagenomic Next-Generation Sequencing (mNGS), meeting the tertiary diagnostic criteria. Preoperative conventional drug treatment, unilateral biportal endoscopic minimally invasive surgery was performed when nutrition was improved, perioperative control of various indexes was stable, and erythrocyte sedimentation was declining. It was completed under an endoscope. The lesion was cleared, spinal nerve compression was relieved, interbody fusion was performed, and the spine was fixed by a percutaneous pedicle screw. Erythrocyte Sedimentation Rate (ESR), C-Reactive Protein (CRP), Visual Analogue Scale (VAS), Japanese Orthopedic Association (JOA) score and Oswestry Disability Index (ODI) were analyzed at 1 month, 3 months, 6 months and the last follow-up. At the final follow-up of all patients, the clinical efficacy criteria and the Bridwell grading criteria were used to evaluate the recovery and intervertebral bone graft fusion, respectively. Results: All patients’ lower back and leg pain was relieved the next day after surgery. At a follow-up of one month after surgery, both systemic and local symptoms significantly improved. At the last follow-up, clinical symptoms disappeared and there was no tenderness or percussion pain in the local area. With the passage of time, 1 month, 3 months, 6 months after the operation, and the last follow-up are all evaluation indicators compared with those before the operation. No matter VAS, JOA, ODI score, or ESR, CRP is significantly improved compared with preoperative (P All 20 cases in this group reached the BS clinical cure standard, and the excellent rate of intervertebral bone graft fusion was 95%. Conclusion: On the basis of .
文摘Recent epidemiological data have revealed an increasing incidence of atlantoaxial (C1–C2) stenosis. In this study, we review the merits and limitations of traditional surgical techniques for the decompression and excision of atlantoaxial stenosis, and introduce a novel biportal endoscopy method. A retrospective analysis was conducted on 1562 cases extracted from 19 articles. These patients, diagnosed with cervical spondylotic myelopathy or cervical spondylosis with various etiologies, underwent surgery using either a posterior biportal endoscopic approach for cervical discectomy or cervical canal decompression. Additionally, we present two cases of atlantoaxial cervical spondylosis treated using the biportal endoscopy approach, yielding positive clinical and radiological outcomes. Common complications associated with spinal endoscopy surgery include dura injury, nerve root injury, hematoma, and recurrence of the condition. While endoscopic cervical spinal surgery shows promising results in terms of efficacy and safety, further detailed assessments of potential complications are necessary.
基金Supported by the Provincial Natural Science Foundation of Gansu,No.24JRRF008Science and Technology Research Project of Songjiang District,No.2024SJKJGG105+1 种基金National Natural Science Foundation of China,No.82202694Clinical Research Innovation Plan of Shanghai General Hospital,No.CTCCR-2021C10.
文摘BACKGROUND This is a retrospective study on endoscopic treatment of cervical spinal radiculopathy(CSR)conducted at a single academic institution.Conventional full-spine endoscopy is performed in a single portal which has certain limitations of high technical requirements,steep learning curve,and narrow indications.Although unilateral biportal endoscopy(UBE)technique has a gentle learning curve and is gradually applied to treat CSR,all procedures were performed in the uniportal working channel that potentially increase the surgical risk and time in the treatment of complex cases.It is worthy to delve novel technique for more working channels in the treatment of complex CSR.AIM To propose a hybrid technique(HT)that utilizes spine endoscopy in UBE to treatment of CSR.METHODS A total of 81 patients with single-segment CSR who underwent uniportal endoscopic surgery(UES),UBE,or HT at a single institution between September 2019 and August 2021 were retrospectively studied.Perioperative patient data were compared between the groups.The pre-operative and post-operative images were compared to confirm adequate decompression of the nerve root canal.Patients'visual analogue scale(VAS)scores and neck disability index(NDI)were recorded before surgery,and three days,three months and six months after surgery.RESULTS The UBE and HT groups had a significantly shorter operation duration than the UES group.Data for bleeding and length of hospital stay were significantly higher in the UBE group than in the UES and HT groups.The hospitalization cost was lowest in the UES group and highest in the HT group.Soft tissue edema reaction bands on postoperative day 3 were larger in the UBE and HT groups than in the UES group.Post-operative VAS and NDI scores were significantly lower in all three groups than the pre-operative levels.On post-operative day 3,the VAS score for neck pain was significantly higher in the UBE and HT groups than that in the UES group.However,there were no significant differences in the VAS scores for arm pain or NDI between the three groups.The post-operative 3-month and 6-month neck pain VAS,arm pain VAS,NDI,and modified Macnab success rates did not differ statistically between the three groups.CONCLUSION The HT for CSR treatment has the advantage of double working channels to facilitate decompression and hemostasis,improving the surgical efficiency and clinical outcomes of CSR.
