Full-endoscopic Spine Surgery for the Treatment of Lumbar Ligamentous Flavum Hematoma

Lumbar ligamentous flavum hematoma (LFH) is a relatively rare pathology, and it is difficult to differentiate it from other cystic lesions. Full-endoscopic spine surgery (FESS), an excellent approach for clear and magnified operative visual field since it allows saline irrigation and minimizes destr...

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Main Authors: Chia-Wei CHANG, Ryoji TOMINAGA, Yasushi OSHIMA, Hiroki IWAI, Hirohiko INANAMI, Hisashi KOGA
Format: Article
Language:English
Published: The Japan Neurosurgical Society 2024-11-01
Series:Neurologia Medico-Chirurgica
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Online Access:https://www.jstage.jst.go.jp/article/nmc/64/11/64_2024-0086/_pdf/-char/en
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author Chia-Wei CHANG
Ryoji TOMINAGA
Yasushi OSHIMA
Hiroki IWAI
Hirohiko INANAMI
Hisashi KOGA
author_facet Chia-Wei CHANG
Ryoji TOMINAGA
Yasushi OSHIMA
Hiroki IWAI
Hirohiko INANAMI
Hisashi KOGA
author_sort Chia-Wei CHANG
collection DOAJ
description Lumbar ligamentous flavum hematoma (LFH) is a relatively rare pathology, and it is difficult to differentiate it from other cystic lesions. Full-endoscopic spine surgery (FESS), an excellent approach for clear and magnified operative visual field since it allows saline irrigation and minimizes destruction of surrounding tissues, has been applied to the treatment. This study aims to present a case series of patients with lumbar LFH treated by FESS. This case series consists of 17 lumbar LFH cases treated by FESS between May 2018 and November 2021 at a single institution. Patient background and operative data were collected from their medical records. The numerical rating scale (NRS), Oswestry Disability Index (ODI), and European Quality of Life-5 Dimensions (EQ-5D) were recorded preoperatively and postoperatively. Elderly men tend to suffer from lumbar LFH at the L4/5 vertebral level. Discontinuity with facet joint was confirmed under endoscopic visualization in all 17 cases. Blood clots were also observed in all cases under endoscope. The mean operative time was 68.6 min without complication. The patients were discharged at average 1.4 days after FESS with significant improvement of NRS score (P < 0.001). ODI and EQ-5D scores 2-year postoperatively statistically improved (P < 0.001), and there was no recurrence during followup period. The operative outcomes of lumbar LFH treated by FESS were satisfactory. FESS excels not only in the diagnosis but also in the treatment of lumbar LFH.
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spelling doaj-art-c2aabe8df6354819a576e19bb3fa606c2025-08-20T02:20:40ZengThe Japan Neurosurgical SocietyNeurologia Medico-Chirurgica1349-80292024-11-01641140140810.2176/jns-nmc.2024-00862024-0086Full-endoscopic Spine Surgery for the Treatment of Lumbar Ligamentous Flavum HematomaChia-Wei CHANG0Ryoji TOMINAGA1Yasushi OSHIMA2Hiroki IWAI3Hirohiko INANAMI4Hisashi KOGA5Department of Orthopedic Surgery, Iwai Orthopedic HospitalDepartment of Orthopedic Surgery, Iwai Orthopedic HospitalDepartment of Orthopedic Surgery, Inanami Spine and Joint HospitalDepartment of Orthopedic Surgery, Iwai Orthopedic HospitalDepartment of Orthopedic Surgery, Iwai Orthopedic HospitalDepartment of Orthopedic Surgery, Iwai Orthopedic HospitalLumbar ligamentous flavum hematoma (LFH) is a relatively rare pathology, and it is difficult to differentiate it from other cystic lesions. Full-endoscopic spine surgery (FESS), an excellent approach for clear and magnified operative visual field since it allows saline irrigation and minimizes destruction of surrounding tissues, has been applied to the treatment. This study aims to present a case series of patients with lumbar LFH treated by FESS. This case series consists of 17 lumbar LFH cases treated by FESS between May 2018 and November 2021 at a single institution. Patient background and operative data were collected from their medical records. The numerical rating scale (NRS), Oswestry Disability Index (ODI), and European Quality of Life-5 Dimensions (EQ-5D) were recorded preoperatively and postoperatively. Elderly men tend to suffer from lumbar LFH at the L4/5 vertebral level. Discontinuity with facet joint was confirmed under endoscopic visualization in all 17 cases. Blood clots were also observed in all cases under endoscope. The mean operative time was 68.6 min without complication. The patients were discharged at average 1.4 days after FESS with significant improvement of NRS score (P < 0.001). ODI and EQ-5D scores 2-year postoperatively statistically improved (P < 0.001), and there was no recurrence during followup period. The operative outcomes of lumbar LFH treated by FESS were satisfactory. FESS excels not only in the diagnosis but also in the treatment of lumbar LFH.https://www.jstage.jst.go.jp/article/nmc/64/11/64_2024-0086/_pdf/-char/enlumbar ligamentous flavum hematomafull-endoscopic spine surgeryminimally invasivecase series
spellingShingle Chia-Wei CHANG
Ryoji TOMINAGA
Yasushi OSHIMA
Hiroki IWAI
Hirohiko INANAMI
Hisashi KOGA
Full-endoscopic Spine Surgery for the Treatment of Lumbar Ligamentous Flavum Hematoma
Neurologia Medico-Chirurgica
lumbar ligamentous flavum hematoma
full-endoscopic spine surgery
minimally invasive
case series
title Full-endoscopic Spine Surgery for the Treatment of Lumbar Ligamentous Flavum Hematoma
title_full Full-endoscopic Spine Surgery for the Treatment of Lumbar Ligamentous Flavum Hematoma
title_fullStr Full-endoscopic Spine Surgery for the Treatment of Lumbar Ligamentous Flavum Hematoma
title_full_unstemmed Full-endoscopic Spine Surgery for the Treatment of Lumbar Ligamentous Flavum Hematoma
title_short Full-endoscopic Spine Surgery for the Treatment of Lumbar Ligamentous Flavum Hematoma
title_sort full endoscopic spine surgery for the treatment of lumbar ligamentous flavum hematoma
topic lumbar ligamentous flavum hematoma
full-endoscopic spine surgery
minimally invasive
case series
url https://www.jstage.jst.go.jp/article/nmc/64/11/64_2024-0086/_pdf/-char/en
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