Discectomia endoscópica transforaminal lombar: Resultados clínicos e complicações

Asano, Leonardo Yukio Jorge; Bergamaschi, João Paulo Machado; Dowling, Álvaro; Rodrigues, Luciano Miller Reis

doi:10.1055/s-0039-1700822

Cited by 5 publications

(3 citation statements)

References 18 publications

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“…Previous series evaluating osteoid osteoma resection had achieved complete pain relief in more than 90% of patients 24 , hence, the benefits of mass resection as a definitive treatment for our patient. However, orthopaedic surgeons should be aware that good results with endoscopic techniques are achieved only with a considerable learning curve 25-27 .…”

Section: Discussionmentioning

confidence: 99%

Complete Endoscopic Resection of an Osteoid Osteoma in the Body of a Thoracic Vertebra

Mangual-Pérez

Martínez-Rivera

Torres-Lugo

et al. 2023

JBJS Case Connector

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Case: A 29-year-old man presented nontraumatic diffuse thoracic pain. Magnetic resonance imaging of the spine showed a cortical lesion with peripheral hyperintensity, a central sclerotic hypointense nidus, and surrounding paraspinal inflammatory changes at the T3 vertebral body. Clinical and radiologic findings were consistent with an osteoid osteoma. The patient successfully underwent an endoscopic partial corpectomy and mass resection. At the 6-month follow-up, radiographs showed complete tumor resolution. Conclusion:Endoscopic resection is an adequate and minimally invasive technique for the complete resection of osteoid osteomas. Neoplastic processes of the spine should be considered when unexplained, spinal axial and postural pain with associated nocturnal predominance, deformities, and positional changes is noted 1 . Historically, the management of neoplastic lesions on the spine included resection, chemotherapy, radiation, or mechanical stabilization based on the type of spine tumor. However, in the early 1990s, percutaneous (ablation) techniques were introduced, and these have been increasingly advocated as a treatment alternative for the resolution of these lesions, especially benign tumors 2 . Since 2012, some reports have described the usage of complete endoscopic techniques 3 . However, the literature regarding the successful application of these minimally invasive procedures, especially in spinal lesions, remains scarce 4 .The patient was informed that data concerning the case would be submitted for publication, and he provided consent. Case ReportDisclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSCC/C15).

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Section: Discussionmentioning

confidence: 99%

Complete Endoscopic Resection of an Osteoid Osteoma in the Body of a Thoracic Vertebra

Mangual-Pérez

Martínez-Rivera

Torres-Lugo

et al. 2023

JBJS Case Connector

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“…Review of the literature shows that endoscopic approaches to the spine are favored given the association with lower blood loss, shorter hospitalization and operative time, and minimal soft-tissue damage. 11 In addition, the incidence of durotomy has been reported to be exceedingly low, occurring in only 5 of 907 patients undergoing transforaminal endoscopic diskectomy by Telfeian et al, 12 only one of which was briefly symptomatic. In our case, the catheter tip's location within the lateral recess was anatomically equivalent to that of a herniated paracentral disk fragment for which a transforaminal approach would normally be used.…”

Section: Discussionmentioning

confidence: 99%

Fractured Lumbar Drain Catheter Retrieval Using an Endoscopic Transforaminal Approach to the Lumbar Spine

Sulhan

Sadrameli

Barber

et al. 2022

Operative Neurosurgery

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BACKGROUND AND IMPORTANCE:Lumbar drain placement is a common neurosurgical procedure, with several surgical and medical indications extending even beyond the specialty. One complication of placement is a fractured catheter fragment. In some circumstances, catheter retrieval is necessary which is classically performed through an open approach. Here, we present the only reported case of a retained lumbar drain catheter which was retrieved using a transforaminal endoscopic approach to the lumbar spine.CLINICAL PRESENTATION:This is a 39 year-old woman who underwent an elective craniotomy with planned perioperative lumbar drain placement for cerebrospinal fluid diversion using a 14-gauge Tuohy needle. Placement was noted to be technically challenging, and during the final attempt on removal of the system, it was noted that the distal end of the catheter had been sheared and retained in the thecal sac. Postoperatively a computed tomography scan of the lumbar spine was obtained showing the catheter fragment which entered the thecal sac dorsally at the L3-4 level but penetrated the ventral dura traveling in the epidural space caudally and terminating in the left lateral recess of L4-5. Given its presumed epidural location near the left L4-5 lateral recess and foramen, the decision was made to attempt a left transforaminal endoscopic approach for catheter retrieval before resorting to a standard open surgery.CONCLUSION:As minimally invasive spine techniques for spine surgery continue to evolve, we have highlighted the versatility of the endoscope in spine surgery as it was implemented in our case, allowing for reduced perioperative morbidity associated with retained spinal catheter retrieval.

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“…Tendo como indicações cirúrgicas, aquelas caracterizadas por fraturas expostas, politraumatismo, extensa lesão de partes moles e lesão neurovascular (GOLNÇALVES et al, 2018). Nesse contexto, com o advento da técnica minimamente invasiva desenvolveu-se também outro conceito denominado como osteossíntese minimamente invasiva com placas possibilitando uma estabilidade relativa a partir de uma fixação biológica sem desvitalização de fragmentos ósseos, de forma que deve ser visualizada como uma das metodologias cirúrgicas eficazes e seguras nessa afecção (ZOGAIB et al, 2014) Diante de outra patologia comumente diagnosticada em adultos, a hérnia discal lombar apresenta-se como uma condição que em maior número leva os pacientes para a sala cirúrgica, especialmente homens por volta dos 40 anos (ASANO et al, 2020). De forma que como implicação de um método menos traumático, a técnica endoscópica reduz condições de morbidade, atribui maior segurança cirúrgica com a visualização mais aproximada de estruturas neurais e índice de infecção baixo ou nulo.…”

Section: Introductionunclassified

Benefícios de procedimentos minimamente invasivos em cirurgias ortopédicas: revisão de literatura

Menezes¹,

Cordeiro²,

Laurindo³

et al. 2022

Braz. J. Hea. Rev.

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Este estudo analisou artigos de revisão sistemática, estudos de meta-análises e ensaios clínicos randomizados e observou os aspectos comparativos entre os procedimento cirúrgicos convencionais e minimamente invasivos. O tratamento cirúrgico visto como o modelo mais invasivo de resolução de infecções ortopédicas, atualmente encontra- se em expansão tanto em na alta demanda de pacientes quanto em relação a introdução de avanços tecnológicos nas diversas técnicas previamente preconizadas. Nesse sentido, a necessidade de promover melhores resultados clínicos e funcionais para os pacientes ortopédicos colabora para a inovação contínua dos equipamentos cirúrgicos, assim como é fomentado a importância da educação continuada entre os cirurgiões. Destacando as principais cirurgias ortopédicas realizadas como fratura de fêmur e artroplastia do joelho visto a incidência relevante, constata-se que a prática das técnicas minimamente invasivas promove inúmeros benefícios ao paciente quando comparadas aos padrões de cirurgia aberta.

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Discectomia endoscópica transforaminal lombar: Resultados clínicos e complicações

Cited by 5 publications

References 18 publications

Complete Endoscopic Resection of an Osteoid Osteoma in the Body of a Thoracic Vertebra

Complete Endoscopic Resection of an Osteoid Osteoma in the Body of a Thoracic Vertebra

Fractured Lumbar Drain Catheter Retrieval Using an Endoscopic Transforaminal Approach to the Lumbar Spine

Benefícios de procedimentos minimamente invasivos em cirurgias ortopédicas: revisão de literatura

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