Palavras-chave► coluna vertebral ► deslocamento do disco invertebral ► avaliação de resultados (cuidados de saúde) ► endoscopia ResumoObjetivo Determinar o tempo de alta hospitalar e o período de melhora funcional e da dor dos pacientes submetidos a discectomia endoscópica percutânea lombar (DEPL). Métodos Avaliação retrospectiva do tempo de internação e dos questionários escala visual análoga (EVA), índice de incapacidade Oswestry (IIO), e Roland-Morris de 32 pacientes submetidos a DEPL nos períodos pré-operatório e com 2 dias, e 1, 2, 4, 6, e 12 semanas pós-operatórias. Resultados Todos os pacientes receberam alta em menos de 6 horas houve melhora estatística entre o período pré-operatório e 2 dias pós-operatório , sendo o valor médio do questionário EVA axial de 6,63 para 3,31, do EVA irradiado de 6,66 para 2,75, do IIO de 44,59% para 33,17% e do Roland-Morris de 14,03 para 10,34. Tal diferença apresentou melhora progressiva até 12 semanas em todos os questionários. O IIO atingiu valores de incapacidade mínima (19,39%) com 6 semanas de avaliação. Conclusão Todos os 32 pacientes receberam alta hospitalar em até 6 horas. Houve melhora significativa dos sintomas funcionais e de dor já com 48 horas, apresentando ainda melhora adicional significativa e progressiva até o 3°mês. AbstractObjective To determine time period for hospital discharge and pain and function improvement in patients submitted to percutaneous endoscopic lumbar discectomy (PELD). Methods Retrospective evaluation of length of stay and visual analog scale (VAS), Oswestry disability index (ODI), and Roland-Morris questionnaire results in 32 patients undergoing PELD at the preoperative period and at 2 days and 1, 2, 4, 6 and 12 postoperative weeks. Results All patients were discharged in less than 6 hours. There was a statistically significant improvement between the results obtained before the procedure and 2 days

To validate the porcine spine as a model for learning and practicing transforaminal percutaneous endoscopic lumbar procedures (TF-PELP). Methods: TF-PELP was performed in three porcine cadaver lumbar spine levels. Anatomical features of the current cadaver were compared to human and porcine spines. Performance and documentation of endoscopic procedures were described. Results: This study shows that this representative animal model reflects anatomical characteristics of the human spine. Transforaminal approaches were successfully completed. Although lower disc heights make disc puncture more difficult, the outside-in technique is feasible and more useful to identify anatomical parameters and to practice different surgical steps and maneuvers. Conclusion: This is an effective and representative model for learning and practicing this procedure. Difficulties of the procedure, as well as the differences compared to the human spine, were described.

Background: Various approaches are used for decompressive surgeries in the thoracic spine depending on the location and consistency of the pathology, always avoiding manipulation of the thoracic spinal cord. Recently, there has been an effort to achieve adequate results and reduce morbidity with minimally invasive surgeries. Good outcomes and the advantages of full endoscopic spine surgery (FESS) have been proven for surgerical correction of herniated discs and stenoses in the lumbar and cervical spine. Similar evidence has recently been described for the thoracic spine, but it has not previously been reported in Brazil. Although the transforaminal approach is already established for the thoracic spine, the newly described interlaminar approach is equally efficient, and both techniques must be considered when treating thoracic spine diseases. The objective of the present article was to present the full endoscopic interlaminar and transforaminal techniques in patients with symptomatic disc herniation of the thoracic spine, discuss the rationality for implementing FESS in thoracic spine, and discuss the rationality in choosing between both approaches.Methods: Two patients were submitted to thoracic FESS. A transforaminal approach was chosen for a T10-T11 foraminal disc herniation; an interlaminar approach was selected for a paramedian T7-T8 disc extrusion. Data regarding operating time, intraoperative images, hospital stay, visual analog scales before and after FESS, course of recovery, and surgery satisfaction were evaluated.Results: The patients had eventless surgeries, improved from preoperative pain without morbidity. Both were satisfied and recovered well. Hospital stay was less than 6 hours after surgery.Conclusions: Transforaminal and interlaminar FESS for thoracic disc herniation are safe, efficient, and minimally invasive alternatives.Clinical Relevance: Despite being an innovative technique with evident advantages, it should be carefully considered along with conventional technique for the treatment of thoracic spine diseases, since its clinical relevance is yet to be determined.

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