Endoscopic Spine Surgery: Distance Patients
Will Travel for Minimally Invasive Spine
Surgery

Telfeian, Albert E.

doi:10.36076/2017.1.e145

Cited by 9 publications

(8 citation statements)

References 14 publications

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“…PTED is a minimally invasive full-endoscopic spine surgical procedure performed principally for the treatment of LDH. 26 It has several advantages in treating recurrent LDH, such as avoiding from the old scar tissue, decreasing operation-related complications, shortening operation time, reducing trauma, and obtaining rapid postoperative recovery. 27 The technique combines the benefits of endoscopy (direct visualization, reduced traumatization, hospital stay, and postsurgical morbidity) with optimal exposure of the intervertebral space and preservation of the dorsal musculature, the vertebrae, and the ligamentous structures.…”

Section: Discussionmentioning

confidence: 99%

Treatment of adjacent segment disease with percutaneous transforaminal endoscopic discectomy: Early experience and results

Kapetanakis

Gkantsinikoudis

Gkasdaris

et al. 2020

J Orthop Surg (Hong Kong)

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Purpose: Adjacent segment disease (ASD) constitutes a long-term complication of instrumented spinal fusion. Aim of this study is to analyze the utilization of percutaneous transforaminal endoscopic discectomy (PTED) for the treatment of symptomatic ASD, emphasizing basically in the postoperative course. Methods: A prospective study with 35 patients was designed. Patients enrolled in our study were distributed in two different groups. Group A constituted of 15 patients featuring ASD as a complication of a previously conducted lumbar spinal fusion. Group B was composed of 20 patients, presenting simple lumbar disc herniation (LDH). All patients were subjected to successful PTED for LDH. Patients were evaluated at regular intervals in 6-week and 3-, 6-, and 12-month postoperatively. Visual analog scale was utilized for leg (VAS-LP) and low back pain (VAS-BP) evaluation. Health-related quality of life was assessed with short-form 36 health survey questionnaire (SF-36). Results: VAS-BP scores were statistically significantly differentiated between the two groups in all intervals of follow-up. In contrast, VAS-LP scores demonstrated statistically significant differentiation in none of follow-up intervals, indicating similar results between the two groups. Maximal improvement was in both cases for all patients observed in 6-week postoperatively, with subsequent stabilization. SF-36 preoperative evaluation denoted a statistically significant differentiation in bodily pain and role emotional parameters, which was continually until the end of follow-up observed. The other SF-36 parameters featured similar values between the two groups preoperatively as well as during the follow-up intervals. Conclusion: PTED is capable of successfully dealing with LDH and furthermore with complications of fusion as ASD.

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Section: Discussionmentioning

confidence: 99%

Treatment of adjacent segment disease with percutaneous transforaminal endoscopic discectomy: Early experience and results

Kapetanakis

Gkantsinikoudis

Gkasdaris

et al. 2020

J Orthop Surg (Hong Kong)

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“…The use of endoscopic techniques in spine surgery has the same advantages as other forms of MISS. Respecting the surrounding tissue, avoiding blood loss, and achieving desired functional outcomes earlier are factors also seen with endoscopic surgery (11). Endoscopic spine surgery was first attempted by Kambin et al in 1988 (10).…”

Section: Arthroscopic/endoscopic Spine Surgerymentioning

confidence: 99%

“…However, it is only recently that the technique has been popularized due to the concurrent advancement in tools and imaging modalities. The use of endoscopic techniques in spine surgery has the same desirable factors as other aspects of MISS of respecting the surrounding tissue, avoiding blood loss, and earlier functional outcomes (11).…”

Section: Arthroscopic/endoscopic Spine Surgerymentioning

confidence: 99%

Current state of minimally invasive spine surgery

et al. 2019

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Newer navigation protocols that rely on intraoperative CT registration have improved the accuracy of imaging models and allowed surgeons to rely less on fluoroscopy. Despite concerns regarding ionizing radiation exposure to the patient, use of CT navigation systems was found to reduce radiation exposure by more than 90% compared to traditional fluoroscopic guided percutaneous surgical techniques (1). Furthermore, the surgeon's exposure to radiation is almost eliminated, as the surgeon does not need to be close to the patient during the CT image registration.The accuracy of navigation has also undergone a huge amount of progress. In addition to higher quality registration, the use of stereotactic 3D cameras allows the system to predict relative position between instruments and anatomical landmarks in real time with higher reliability (2). Amiot et al. and Yu et al. (3,4). both demonstrated that freehand pedicle screw (PS) placement had a higher rate of error and reoperation compared to navigation assisted placement. The same results were reflected in a meta-analysis of 12 studies conducted by Shin et al. (5) However, many other meta-analyses in the literature have failed to demonstrate superiority of computer assisted navigation to free hand PS instrumentation perhaps due to the heterogeneity of studies included. The accuracy of navigation has also undergone a lot of progress. In additional to higher quality registration, the use of stereotactic 3D cameras allows the system to predict relative position between instruments and anatomical landmarks in real time with higher reliability (2). Amiot et al. and Yu et al. (3,4) both demonstrated that freehand PS placement had a higher rate of error and reoperation compared to navigation assisted placement. Shin et al. completed a meta-analysis of 12 studies which also reflected the same results (5). However, many other meta-analyses in the literature have failed to demonstrate superiority of computer assisted navigation to free hand PS instrumentation perhaps due to the heterogeneity of studies included.Navigation systems rely on the use of reference trackers to keep the registration image in sync throughout the operation regardless of the positioning of the patient. Multiple modalities of anatomic tracking are in use. Pin trackers that are inserted into bony landmarks allow for accurate mapping with relatively few trackers, however

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“…Transforaminal Endoscopic Discectomy for Central Disc Herniation Since the invention of Yeung Endoscopic Spine System (YESS) technology by Anthony Yeung in 1999, percutaneous transforaminal endoscopic disectomy has been widely used in the treatment of LDH and has achieved good results (11,12). Yeung et al (13) reported 307 cases of LDH treated with the YESS technique followed-up for more than one year, and the www.painphysicianjournal.com excellent-to-good rate was 89.3%.…”

Section: E119mentioning

confidence: 99%

Transforaminal Endoscopic Discectomy for Treatment of Central Disc Herniation: Surgical Techniques and Clinical Outcome

Zhang

2018

Pain Phys

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Background: Though transforaminal endoscopic discectomy has achieved a satisfactory clinical outcome in the treatment of paracentral disc herniation, it has a high failure rate for treating central disc herniation. Objective: To explore the surgical techniques of transforaminal endoscopic discectomy in treating central disc herniation and the clinical outcome based on 2-year follow-up. Study Design: A retrospective study. Setting: The Department of Spinal Surgery at the Third Hospital of Hebei Medical University in China. Methods: Sixty-nine consecutive patients (male:female = 14:9, mean age 38.8 ± 10.5 years) were enrolled in the study, all of whom underwent transforaminal endoscopic discectomy due to central disc herniation. The rod adjustment technique, apex technique, and posterior longitudinal ligament detection technique were adopted for intraoperative individualization. All of the patients were followed up for 24 months to assess the visual analog scale (VAS), Japanese Orthopaedic Association (JOA), and Oswestry Disability Index (ODI) scores. The postoperative segmental instability and recurrence were observed during the follow-up period as well. MacNab criteria scores were recorded both intraoperatively and at the final follow-up; postoperative complications and the surgical outcome and safety were also evaluated. Results: The herniated disc tissues were successfully removed for all patients, without revision by open surgery. Twenty-one cases (30.43%) were rated excellent, 44 (63.77%) good, 4 (5.80%) fair, and 0 (0.00%) poor upon the final follow-up, with an overall excellent-to-good rate of 86.96%. The VAS scores of low back and leg pain were all significantly lower at 3, 6, 12, and 24 months postoperatively compared to preoperatively (all P < 0.05). The JOA scores at the 3-month and 24-month postoperative follow-ups were significantly higher than the preoperative values (all P < 0.05). The ODI evaluation was significantly lower at 3 and 24 months postoperatively than preoperatively (all P < 0.05). Limitations: The retrospective nature of this study is a limitation, as well as the small sample size and short observation time. Conclusion: The application of novel surgical techniques can help improve the safety and efficacy of transforaminal endoscopic discectomy in treating central disc herniations. Intraoperative individualized application of rod adjustment technique, apex technique, or posterior longitudinal ligament detection technique is the key to satisfactory clinical outcome. Key words: Central disc herniation, rod adjustment technique, transforaminal endoscopy, minimal invasion, complication

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Endoscopic Spine Surgery: Distance Patients Will Travel for Minimally Invasive Spine Surgery

Cited by 9 publications

References 14 publications

Treatment of adjacent segment disease with percutaneous transforaminal endoscopic discectomy: Early experience and results

Treatment of adjacent segment disease with percutaneous transforaminal endoscopic discectomy: Early experience and results

Current state of minimally invasive spine surgery

Transforaminal Endoscopic Discectomy for Treatment of Central Disc Herniation: Surgical Techniques and Clinical Outcome

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