A new approach for observing cerebral cisterns and ventricles via a percutaneous lumbosacral route by using fine, flexible fiberscopes

Shimoji, Koki; Ogura, Mai; Gamou, Sanae; Yunokawa, Seki; Sakamoto, Hidetoshi; Fukuda, Satoru; Morita, Shigeho

doi:10.3171/2007.12.17287

Cited by 11 publications

(5 citation statements)

References 20 publications

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“…7,28 Shimoji et al 26 reported that they successfully advanced a fiberscope to the fourth and third ventricles via a percutaneous route. Karakhan et al 14 described different approaches, including a dorsal paramedian approach to the intradural space via interlaminar fenestration or hemilaminectomy.…”

Section: Discussionmentioning

confidence: 99%

Arachnoscopy: a special application of spinal intradural endoscopy

Mauer¹,

Gottschalk²,

Kunz³

et al. 2011

FOC

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Object The microsurgical removal of obstructions to CSF flow is the treatment of choice in the surgical management of intradural arachnoid cysts. Cardiac-gated phase-contrast MR imaging is an effective tool for the primary diagnosis and localization of arachnoid cysts. Microsurgery, however, does not lend itself to assessments of further adhesions beyond the borders of the exposed area. The use of a thin endoscope allows surgeons to assess intraoperatively whether the exposure is wide enough. Methods Between 2006 and 2010, a single neurosurgeon performed 31 consecutive microsurgical procedures with endoscopic assistance in 28 patients with spinal arachnoid adhesions. A MurphyScope endoscope was used for this purpose. The CSF flow was studied before and after surgery in all patients by using phase-contrast MR imaging in the region of the craniocervical junction, the cervical spine, the thoracic spine, and the lumbar spine. Results In all 31 procedures, CSF flow obstructions were detected at the level identified by phase-contrast MR imaging. In 29 procedures, image quality was sufficient for an inspection of the adjacent subarachnoid space. In 6 cases, the surgeon detected further adhesions that obstructed CSF flow in the adjacent subarachnoid space that were not visualized with the microscope. In all cases, these adhesions were identified and removed during microsurgery. Conclusions Arachnoscopy is a helpful adjunct to microsurgery and can be performed safely and easily. It allows the surgeon to detect further adhesions in the subarachnoid space that would remain undetected by microscopy alone.

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Section: Discussionmentioning

confidence: 99%

Arachnoscopy: a special application of spinal intradural endoscopy

Mauer¹,

Gottschalk²,

Kunz³

et al. 2011

FOC

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“…A subarachno-epidurostomy creates a pressure gradient that keeps the stoma open (as in the case of a third ventriculocisternostomy) and leads to a long-term improvement in CSF fl ow. It is interesting that recently fi beroscopy via the lumbosacral route has been suggested as a novel approach to observe cerebral ventricles and cisterns; in a series of 31 patients, chronic arachnoiditis necessitated interruption of the procedure in 6 patients [23] .…”

Section: Thecaloscopy Techniquementioning

confidence: 99%

Lumbar Arachnoiditis and Thecaloscopy: Brief Review and Proposed Treatment Algorithm

Ieva¹,

Barolat²,

Tschabitscher

et al. 2009

Cen Eur Neurosurg

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The term arachnoiditis describes the inflammation of the meninges and subarachnoid spaces. Lumbar arachnoiditis is characterized by obliterated nerve root sleeves and the adherence of nerve roots to each other in the proximity of the cauda equina, and may be secondary to infectious diseases or tumors, iatrogenic (subsequent to spinal surgery) or idiopathic. It is not very clearly defined epidemiologically or clinically, and various theories regarding its pathophysiology have been proposed; furthermore, its treatment is difficult because there is a lack of evidence-based diagnostic and therapeutic gold standards. Thecaloscopy has been recently described as a novel technique for retrograde transcutaneous neuroendoscopic inspection of the subarachnoid structures of the lumbar thecal sac; it has also been suggested for the treatment of lumbar arachnoiditis. We here review the most modern techniques for the treatment of this disease such as thecaloscopy and neurostimulation.

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“…Diagnosis and/or treatment of tethered cord syndrome, arachnoiditis, and spinal subdural hematoma can be established. [23][24][25][26] A novel endoscopic technique for the visualization and surgical manipulation of the filum terminale with no assistance from a loupe or microscope was described and supported with Key words -Filum terminale -Interlaminar -Minimal invasive spine surgery -Spinal endoscopy -Tethered cord syndrome -Untethering histopathologic examination. The utility, safety, and feasibility of this method were investigated in fresh postmortem adult human cadavers.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Fully Endoscopic İnterlaminar Approach to the Filum Terminale: A Cadaveric Study

Yörükoğlu¹,

Tahta

Akçakaya

et al. 2016

World Neurosurgery

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A new approach for observing cerebral cisterns and ventricles via a percutaneous lumbosacral route by using fine, flexible fiberscopes

Abstract: The approach to the supraspinal structures via the lumbosacral route by using a fine, flexible fiberscope may provide a new, minimally invasive, and safe way to observe the cerebral cisterns and/or brainstem regions.

Cited by 11 publications

References 20 publications

Arachnoscopy: a special application of spinal intradural endoscopy

Arachnoscopy: a special application of spinal intradural endoscopy

Lumbar Arachnoiditis and Thecaloscopy: Brief Review and Proposed Treatment Algorithm

Percutaneous Fully Endoscopic İnterlaminar Approach to the Filum Terminale: A Cadaveric Study

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