Destandau’s Approach to the Cervical and Thoracic Spine

Abstract

Objective: Destandau’s endospine technique was initially described for lumbar disc herniation and was later applied for lumbar spinal stenosis. Favorable outcomes have been reported with this technique for lumbar degenerative pathology. This article attempts to review the literature and define the scope of Destandau’s technique in cervical and thoracic pathologies.Methods: A literature search for the keywords “Destandau” and “endospine” was performed in the PubMed, Cochrane, Scopus, Embase, and MEDLINE databases. The review was conducted according to the Scale for the Assessment of Narrative Review Articles (SANRA) tool.Results: In total, 91 studies were found, out of which three studies employed Destandau’s endospine technique for cervical and thoracic pathologies. Three book chapters describing the Destandau technique in cervical pathology and intradural tumor excision were also included in the review. The technique has been successfully employed by various authors for an anterior or posterior cervical approach to disc herniation, cord decompression, and excision of intradural extra-medullary lesions of the spinal canal. No studies mentioned using the Destandau technique for thoracic disc herniation, traumatic fractures, or ossified ligamentum flavum decompression. Conclusion: Destandau’s endoscopic technique has been applied successfully in anterior and posterior cervical approaches for cervical disc herniation, myelopathy and intradural tumors, and its advantages include less pain, minimal muscle damage, shorter hospital stays, and the preservation of spinal stability/segment mobility. Further studies comparing various techniques would help choose the most patient-friendly technique for specific pathologies.

Evolution, Current Trends, and Latest Advances of Endoscopic Spine Surgery

“…In the same year, Destandau’s Endospine technique was introduced by Dr J. Destandau, based on the principle of laparoscopic triangulation between an endoscope and suction with a working instrument. The system is composed of three tubes: one for the endoscope, one for aspiration, and the largest one for standard surgical instruments [ 17 , 18 ]. In the 1990s, Yeung developed an operating spine scope with a working channel and introduced beveled and slotted cannulas and, subsequently, allowed for direct visualization and surgical removal of disc material and foraminal decompression (foraminoplasty) through a single port [ 19 , 20 ].…”