Complications and Management of Endoscopic Spinal Surgery

Ju, Chang Il; Lee, Seung Myung

doi:10.14245/ns.2346226.113

Cited by 44 publications

(18 citation statements)

References 163 publications

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“…Previous research has indicated that a dural tear is the most common complication associated with UBE. 16 Several risk factors have been identified, including instrument or radiofrequency-induced damage to the dura mater, adhesion in the spinal canal, presence of giant disc fragments, and loosened dura. 17 , 18 Therefore, meticulous dissection of the meningo-vertebral ligament is of particular importance.…”

Section: Discussionmentioning

confidence: 99%

Unilateral Biportal Endoscopic Discectomy versus Percutaneous Endoscopic Interlaminar Discectomy for Lumbar Disc Herniation

Wei,

Dang,

Liu

et al. 2024

JPR

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Background As the latest endoscopic spine surgery, percutaneous endoscopic interlaminar discectomy (PEID) and unilateral biportal endoscopic (UBE) discectomy have distinct technical characteristics. This study aimed to evaluate the clinical outcomes of PEID and UBE discectomy in the treatment of single-level lumbar disc herniation (LDH). Methods Between February 2019 and April 2022, 115 patients with single-level LDH at L4-5 or L5-S1 received PEID or UBE discectomy. The patients were separated into two groups based on the surgical method used: Group 1 (the PEID group) (n = 60) and Group 2 (the UBE group) (n = 55). Various parameters, including operative time, hospitalization time, fluoroscopy frequency, total costs, complications, visual analogue scale (VAS), and Oswestry Disability Index (ODI), were evaluated and compared between the two groups. Results There were no significant differences in the VAS and ODI scores in 12 months after the operation between two groups ( P > 0.05). However, the VAS of lower back pain on the first day after the operation in Group 2 (2.53±0.89) was higher than that in Group 1 (2.19±0.74) ( P < 0.05). There were no significant differences in the operation time and incidence of complications between two groups ( P > 0.05). But total costs in Group 2 (43,121±4280) were significantly higher than those in Group 1 (30,069±3551) ( P < 0.05). Conclusion Both UBE and PEID procedures have similar efficacy in alleviating pain and improving functional ability in patients with LDH. However, UBE surgery results in higher costs than PEID surgery.

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Section: Discussionmentioning

confidence: 99%

Unilateral Biportal Endoscopic Discectomy versus Percutaneous Endoscopic Interlaminar Discectomy for Lumbar Disc Herniation

Wei,

Dang,

Liu

et al. 2024

JPR

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“…Foraminotomy for LFS offers the benefits of motion preservation and reduced concern about adjacent segment degeneration, but it also appears to have disadvantages compared to fusion. According to the review of Ju and Lee [ 22 ]. for complications following foraminotomy, the primary complications include recurrent stenosis with incidental durotomy, motor weakness, and dysesthesia.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors of Restenosis After Full Endoscopic Foraminotomy for Lumbar Foraminal Stenosis: Case-Control Study

Seo,

Ju,

Kim

et al. 2023

Neurospine

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Objective: To investigate risk factors associated with postoperative restenosis after full endoscopic lumbar foraminotomy (FELF) in patients with lumbar foraminal stenosis (LFS).Methods: A single-center, retrospective case-control study was conducted on patients diagnosed with foraminal stenosis who underwent FELF between August 2019 and April 2022. The study included 56 patients, comprising 18 cases and 38 controls. Clinical data, radiologic assessments, and surgical types were compared between the groups. The cutoff values of radiologic parameters that differentiate the 2 groups were investigated.Results: No significant difference in age, sex distribution, or presence of adjacent segment disease or grade I spondylolisthesis was observed between the groups. Cases had a higher degree of disc wedging angle (DWA) (3.0° ± 1.1° vs. 0.5° ± 1.4°, p < 0.001), larger coronal Cobb angle (CCA) (8.8° ± 5.1° vs. 4.7° ± 2.5°, p = 0.004), and smaller segmental lumbar lordosis (SLL) than controls (11.0 ± 7.4 vs. 18.0 ± 5.4, p = 0.001). Optimal cutoff values for DWA, CCA, and SLL were estimated as 1.8°, 7.9°, and 17.1°, respectively. A significant difference in surgical types was observed between cases and controls (p = 0.004), with the case group having a higher distribution of patients undergoing discectomy in addition to TELF.Conclusion: The study identified potential risk factors for restenosis after FELF in patients with LFS, including higher DWA, larger CCA, smaller SLL angle. We believe that discectomy should be perform with caution during FELF, as it can lead to subsequent restenosis.

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“…However, UBESS has a low incidence of postoperative infection due to factors such as continuous saline irrigation, shorter operation time, and reduced soft tissue injury [24].…”

Section: Infectionmentioning

confidence: 99%

Overview and Prevention of Complications During Biportal Endoscopic Lumbar Spine Surgery

Lee,

Shin,

et al. 2023

J Minim Invasive Spine Surg Tech

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Unilateral biportal endoscopic spine surgery (UBESS) is a minimally invasive surgical technique that has gained popularity for its potential benefits in various spinal lesions. It involves 2 small incisions, providing wide and clear endoscopic visualization, and causes less soft tissue damage than open surgery. UBESS offers flexibility and versatility in approaching different spinal disorders, including decompression of the spinal cord and root in the cervical or thoracic spine, as well as lumbar discectomy and spinal stenosis. One of the strengths of UBESS is its similarity to microscopic techniques, allowing for 2-handed endoscopic surgery. This familiarity makes it easier for surgeons to adopt endoscopic techniques and overcome the learning curve associated with spine endoscopy. However, some potential complications are associated with biportal endoscopic spine surgery, including dural tear, epidural hematoma, infection, incomplete surgery, and neural injury. Although the overall incidence of these complications is relatively low, it is important for clinicians to be aware of them and understand preventive methods.

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Complications and Management of Endoscopic Spinal Surgery

Cited by 44 publications

References 163 publications

Unilateral Biportal Endoscopic Discectomy versus Percutaneous Endoscopic Interlaminar Discectomy for Lumbar Disc Herniation

Unilateral Biportal Endoscopic Discectomy versus Percutaneous Endoscopic Interlaminar Discectomy for Lumbar Disc Herniation

Risk Factors of Restenosis After Full Endoscopic Foraminotomy for Lumbar Foraminal Stenosis: Case-Control Study

Overview and Prevention of Complications During Biportal Endoscopic Lumbar Spine Surgery

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