PMC7434627_01
(A) Normal lumbar curve and alignment; (B) sagittal location map; (C) L5/S1 disk herniation; (D) L4/5 ligamentum flavum hypertrophy; (E) L3/4 ligamentum flavum hypertrophy; (F) L2/3 ligamentum flavum hypertrophy.
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In MRI results (Figure 1), lumbar curvature was normal and anterior and posterior margins of multiple vertebral bodies rough and sharp.
(A) Needle-knife insertion point on the body surface: (B) angle and depth for L2/3; (C) angle and depth for L3/4; (D) angle and depth for L4/5.
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The angle and depth of the needle on the left and right sides of the L2/3, L3/4, and L4/5 segments were measured on the CT-scan image and the needle-insertion point marked on the body surface (Figure 2).
(A) Needle-knife position on the body surface: (B) for L2/3; (C) for L3/4; (D) for L4/5. (E) 3-D reconstruction.
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The facet joint was punctured with the needle knife, the direction and depth of the needle adjusted to the edge of the lower facet, and the position reconfirmed by CT scan (Figure 3).
(A) The needle-knife used in the surgery; (B) intraoperative blood loss; (C) postoperative body-surface situation.
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After surgery, there was a small amount of hemorrhage, no infection, ecchymoma, headache, dizziness, or numbness, and pain and weakness of the lower limbs and other complications (Figure 4).