Objective:To evaluate the application of spinal endoscopy in treating elderly patients with osteoporotic lumbar spinal stenosis,and to assess its impact on pain relief,functional improvement,and postoperative satisfac...Objective:To evaluate the application of spinal endoscopy in treating elderly patients with osteoporotic lumbar spinal stenosis,and to assess its impact on pain relief,functional improvement,and postoperative satisfaction.Methods:A total of 86 elderly patients with osteoporotic lumbar spinal stenosis who underwent surgery at our hospital from March 1,2023,to February 28,2024,were selected.These patients were divided into an observation group(spinal endoscopy,n=44)and a control group(traditional open decompression,n=42).Preoperative,1 month postoperatively,and 3 months postoperatively,visual analog scale(VAS),Oswestry functional disability index(ODI),and patient satisfaction were assessed.Intraoperative blood loss,hospital stay,and the incidence of postoperative complications were compared as safety indicators.Data analysis was performed using SPSS 26.0 software.Measurement data were presented as mean±standard deviation,and inter-group comparisons were conducted using independent samples t-tests.Categorical data were analyzed using χ^(2) tests.Results:One month and three months postoperatively,the VAS scores in the observation group were 2.8±0.6 and 1.9±0.4,respectively,significantly lower than those in the control group(3.6±0.7 and 2.7±0.5)(P=0.015,P=0.008).The ODI scores were 24.3±4.5 and 17.8±3.2,respectively,also significantly better than those in the control group(30.6±5.1 and 22.9±3.7)(P=0.021,P=0.010).The observation group had a median intraoperative blood loss of 52.6±13.8 mL and an average hospital stay of 4.3±1.2 days,significantly lower than the control group's 108.4±21.5 mL and 7.2±1.6 days(P<0.001).The postoperative complication rate in the observation group was 4.5%(2/44),compared to 16.7%(7/42)in the control group(P=0.043).Postoperative satisfaction scores were 92.6±4.1 for the observation group and 84.7±5.6 for the control group(P<0.001).Conclusion:The application of spinal endoscopy technology in elderly patients with osteoporotic lumbar spinal stenosis can effectively reduce postoperative pain,improve functional status,minimize intraoperative trauma and complications,and significantly enhance patient satisfaction,demonstrating excellent clinical value for widespread adoption.展开更多
Real-time water-medium endoscopic images can assist doctors in performing operations such as tissue cleaning and nucleus pulpous removal.During medical operating procedures,it is inevitable that tissue particles,debri...Real-time water-medium endoscopic images can assist doctors in performing operations such as tissue cleaning and nucleus pulpous removal.During medical operating procedures,it is inevitable that tissue particles,debris and other contaminants will be suspended within the viewing area,resulting in blurred images and the loss of surface details in biological tissues.Currently,few studies have focused on enhancing such endoscopic images.This paper proposes a water-medium endoscopic image processing method based on dual transmittance in accordance with the imaging characteristics of spinal endoscopy.By establishing an underwater imaging model for spinal endoscopy,we estimate the transmittance of the endoscopic images based on the boundary constraints and local image contrast.The two transmittances are then fused and combined with transmittance maps and ambient light estimations to restore the images before attenuation,ultimately enhancing the details and texture of the images.Experiments comparing classical image enhancement algorithms demonstrate that the proposed algorithm could effectively improve the quality of spinal endoscopic images.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
BACKGROUND Percutaneous endoscopic lumbar decompression(PELD)shows promise for lumbar spinal stenosis(LSS)treatment,but its use is limited by the disease's complexity and procedural challenges.AIM In this study,th...BACKGROUND Percutaneous endoscopic lumbar decompression(PELD)shows promise for lumbar spinal stenosis(LSS)treatment,but its use is limited by the disease's complexity and procedural challenges.AIM In this study,the effects of preoperative planning and intraoperative guidance with computed tomography(CT)/magnetic resonance imaging(MRI)registration techniques on PELD for LSS and postoperative rehabilitation outcomes were evaluated.METHODS This retrospective study was conducted with data from patients who underwent PELD for LSS between January 2021 and December 2023.Patients were assigned to preoperative CT/MRI registration and control groups.Data collected included the operative time,length of hospital stay,visual analog scale(VAS)scores for low back and leg pain,and the Japanese Orthopaedic Association(JOA)lumbar spine score.Differences between groups were assessed using Student’s t test.RESULTS Data from 135 patients(71 in the CT/MRI registration group,64 in the control group)were analyzed.The operative time was significantly shorter in the CT/MRI registration group(P=0.007).At 2 months postoperatively,both groups showed significant reductions in VAS leg and low back pain scores(all P<0.001)and improvements in the JOA score(both P<0.001).No complication or death occurred.Preoperatively,pain and JOA scores were similar between groups(P=0.830,P=0.470,and P=0.287,respectively).At 2 months postoperatively,patients in the CT/MRI registration group reported lower leg and low back pain levels(P<0.001 and P=0.001,respectively)and had higher JOA scores(P=0.004)than did patients in the control group.CONCLUSION Preoperative CT/MRI registration for PELD for LSS reduced the operative time and VAS pain scores at 2 months and improved JOA scores,demonstrating enhanced effectiveness and safety.展开更多
文摘Objective:To evaluate the application of spinal endoscopy in treating elderly patients with osteoporotic lumbar spinal stenosis,and to assess its impact on pain relief,functional improvement,and postoperative satisfaction.Methods:A total of 86 elderly patients with osteoporotic lumbar spinal stenosis who underwent surgery at our hospital from March 1,2023,to February 28,2024,were selected.These patients were divided into an observation group(spinal endoscopy,n=44)and a control group(traditional open decompression,n=42).Preoperative,1 month postoperatively,and 3 months postoperatively,visual analog scale(VAS),Oswestry functional disability index(ODI),and patient satisfaction were assessed.Intraoperative blood loss,hospital stay,and the incidence of postoperative complications were compared as safety indicators.Data analysis was performed using SPSS 26.0 software.Measurement data were presented as mean±standard deviation,and inter-group comparisons were conducted using independent samples t-tests.Categorical data were analyzed using χ^(2) tests.Results:One month and three months postoperatively,the VAS scores in the observation group were 2.8±0.6 and 1.9±0.4,respectively,significantly lower than those in the control group(3.6±0.7 and 2.7±0.5)(P=0.015,P=0.008).The ODI scores were 24.3±4.5 and 17.8±3.2,respectively,also significantly better than those in the control group(30.6±5.1 and 22.9±3.7)(P=0.021,P=0.010).The observation group had a median intraoperative blood loss of 52.6±13.8 mL and an average hospital stay of 4.3±1.2 days,significantly lower than the control group's 108.4±21.5 mL and 7.2±1.6 days(P<0.001).The postoperative complication rate in the observation group was 4.5%(2/44),compared to 16.7%(7/42)in the control group(P=0.043).Postoperative satisfaction scores were 92.6±4.1 for the observation group and 84.7±5.6 for the control group(P<0.001).Conclusion:The application of spinal endoscopy technology in elderly patients with osteoporotic lumbar spinal stenosis can effectively reduce postoperative pain,improve functional status,minimize intraoperative trauma and complications,and significantly enhance patient satisfaction,demonstrating excellent clinical value for widespread adoption.
文摘Real-time water-medium endoscopic images can assist doctors in performing operations such as tissue cleaning and nucleus pulpous removal.During medical operating procedures,it is inevitable that tissue particles,debris and other contaminants will be suspended within the viewing area,resulting in blurred images and the loss of surface details in biological tissues.Currently,few studies have focused on enhancing such endoscopic images.This paper proposes a water-medium endoscopic image processing method based on dual transmittance in accordance with the imaging characteristics of spinal endoscopy.By establishing an underwater imaging model for spinal endoscopy,we estimate the transmittance of the endoscopic images based on the boundary constraints and local image contrast.The two transmittances are then fused and combined with transmittance maps and ambient light estimations to restore the images before attenuation,ultimately enhancing the details and texture of the images.Experiments comparing classical image enhancement algorithms demonstrate that the proposed algorithm could effectively improve the quality of spinal endoscopic images.
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.
基金Supported by Health Commission of Shanxi Province,No.2021XM39.
文摘BACKGROUND Percutaneous endoscopic lumbar decompression(PELD)shows promise for lumbar spinal stenosis(LSS)treatment,but its use is limited by the disease's complexity and procedural challenges.AIM In this study,the effects of preoperative planning and intraoperative guidance with computed tomography(CT)/magnetic resonance imaging(MRI)registration techniques on PELD for LSS and postoperative rehabilitation outcomes were evaluated.METHODS This retrospective study was conducted with data from patients who underwent PELD for LSS between January 2021 and December 2023.Patients were assigned to preoperative CT/MRI registration and control groups.Data collected included the operative time,length of hospital stay,visual analog scale(VAS)scores for low back and leg pain,and the Japanese Orthopaedic Association(JOA)lumbar spine score.Differences between groups were assessed using Student’s t test.RESULTS Data from 135 patients(71 in the CT/MRI registration group,64 in the control group)were analyzed.The operative time was significantly shorter in the CT/MRI registration group(P=0.007).At 2 months postoperatively,both groups showed significant reductions in VAS leg and low back pain scores(all P<0.001)and improvements in the JOA score(both P<0.001).No complication or death occurred.Preoperatively,pain and JOA scores were similar between groups(P=0.830,P=0.470,and P=0.287,respectively).At 2 months postoperatively,patients in the CT/MRI registration group reported lower leg and low back pain levels(P<0.001 and P=0.001,respectively)and had higher JOA scores(P=0.004)than did patients in the control group.CONCLUSION Preoperative CT/MRI registration for PELD for LSS reduced the operative time and VAS pain scores at 2 months and improved JOA scores,demonstrating enhanced effectiveness and safety.
