Full Endoscopic Surgery for Thoracic Pathology: Next Step after Mastering Lumbar and Cervical Endoscopic Spine Surgery?

Bae, Junseok; Lee, Sang-Ho; Wagner, Ralf; Shen, Jian Ren; Telfeian, Albert E.

doi:10.1155/2022/8345736

Cited by 8 publications

(6 citation statements)

References 23 publications

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“…The excellent as well as good outcomes and the advantages of full-endoscopic spine surgery have been proven for the treatment of herniated discs and stenoses in the lumbar and cervical vertebrae (11,17,18). Additionally, the next step after mastering lumbar and cervical endoscopic spinal surgery is managing the thoracic pathology with the full-endoscopic technique (19). Recently, many surgeons worldwide tried various minimally invasive surgery techniques, such as surgery-transforaminal lumbar interbody fusion, video-assisted thoracoscopic surgery, microendoscopic surgery, and full-endoscopic surgery, to treat thoracic pathology (4,9,(20)(21)(22).…”

Section: Discussionmentioning

confidence: 99%

Fully endoscopic transforaminal discectomy for thoracolumbar junction disc herniation with or without calcification under general anesthesia: Technical notes and preliminary outcomes

Meng

Han

et al. 2023

Front. Surg.

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ObjectiveTo evaluate the feasibility, safety, and outcomes of percutaneous endoscopic transforaminal discectomy (PETD) for thoracolumbar junction disc herniation (TLDH) with or without calcification.MethodsThis study included 12 patients diagnosed with TLDH with or without calcification who met the inclusion criteria and underwent surgery for PETD from January 2019 to December 2021. The mean patient age, operation time, hospitalization time, time in bed, and complications were recorded. Patients were followed up for at least 9 months. Visual analog scale (VAS) scores for low-back and leg or thoracic radicular pain and modified Japanese Orthopedic Association score (m-JOA) scores were preoperatively evaluated, at 1 day and 3, 6, and 12 months postoperatively or at last follow-up. The modified MacNab criteria were used to evaluate clinical efficacy at 12 months postoperatively or at last follow-up.ResultsThe mean patient age, operation time, hospitalization time, and time in bed were 53 ± 13.9 years, 101.3 ± 9.2 min, 4.5 ± 1.3 days, and 18.0 ± 7.0 h, respectively. The mean VAS scores of low-back and leg or thoracic radicular pain improved from 5.8 ± 1.5 and 6.5 ± 1.4 to 2.0 ± 0.9 and 1.3 ± 0.5, respectively (P < 0.05). The m-JOA score improved from 7.5 ± 1.2 to 10.0 ± 0.7 (P < 0.05). The overall excellent–good rate of the modified MacNab criteria was 83.3%. No severe complications occurred.ConclusionFully endoscopic transforaminal discectomy and ventral decompression under general anesthesia is a safe, feasible, effective, and minimally invasive method for treating herniated discs with or without calcification at thoracolumbar junction zone.

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Section: Discussionmentioning

confidence: 99%

Fully endoscopic transforaminal discectomy for thoracolumbar junction disc herniation with or without calcification under general anesthesia: Technical notes and preliminary outcomes

Meng

Han

et al. 2023

Front. Surg.

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“…After reaching the plateau of the learning curve, the full-endoscopic technique can be performed with a surgical time comparable to that of other techniques but with less bleeding, a shorter hospital stay, less postoperative pain, and a shorter rehabilitation time [1,2,6]. After several years, some authors [37][38][39] demonstrated the effectiveness of the technique on the thoracic spine, with an improvement in pain intensity and neurological deficit in patients with hypertrophy or calcification of the ligamentum flavum. The presence of the spinal cord may at first glance cause concern among spine surgeons, but the full-endoscopic technique may be a good option in the treatment of posterior central compression in the thoracic spine, with few reported complications [37][38][39].…”

Section: Discussionmentioning

confidence: 99%

Surgical Technique of Central and Over-the-Top Full-Endoscopic Decompression of the Cervical Spine: A Technical Note

Bergamaschi,

Brito,

Araújo

et al. 2023

JPM

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Endoscopic surgery of the cervical spine is constantly evolving and the spectrum of its indications has expanded in recent decades. Full-endoscopic techniques have standardized the procedures for posterior and anterior access. The full-endoscopic approach was developed to treat degenerative diseases with the least possible invasion and without causing instability of the cervical spine. The posterior full-endoscopic approach is indicated for the treatment of diseases of the lateral part of the vertebral segment, such as herniations and stenoses of the lateral recess and vertebral foramen. There has been little discussion of this approach to the treatment of central stenosis of the cervical spine. This technical note describes a step-by-step surgical technique for central and over-the-top full-endoscopic decompression in the cervical spine, using a 3.7 mm working channel endoscope. This technique has already been shown to be effective in a recent case series with a 4.7 mm working channel endoscope, and may represent a new treatment option for central or bilateral lateral recess stenosis. There is also the possibility of a bilateral full-endoscopic approach, but this may be associated with greater muscle damage and a longer operative time. Case series and comparative studies should be encouraged to confirm the safety and utility of this technique.

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“…Typically, patients with LSS have a variety of conservative options including pain medications and physical therapy. Surgical intervention for LSS is common in cases when patients begin to see neurological deterioration and symptoms [ 115 , 116 ]. The standard of care has been decompression surgery, requiring significant manipulation of spinal muscles [ 116 ].…”

Section: Emerging Treatment Optionsmentioning

confidence: 99%

“…Surgical intervention for LSS is common in cases when patients begin to see neurological deterioration and symptoms [ 115 , 116 ]. The standard of care has been decompression surgery, requiring significant manipulation of spinal muscles [ 116 ]. This approach has been seen to increase the risk of postoperative complications [ 117 ].…”

Section: Emerging Treatment Optionsmentioning

confidence: 99%

Differentiating Lumbar Spinal Etiology from Peripheral Plexopathies

et al. 2023

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Clinicians have managed and treated lower back pain since the earliest days of practice. Historically, lower back pain and its accompanying symptoms of radiating leg pain and muscle weakness have been recognized to be due to any of the various lumbar spine pathologies that lead to the compression of the lumbar nerves at the root, the most common of which is the radiculopathy known as sciatica. More recently, however, with the increased rise in chronic diseases, the importance of differentially diagnosing a similarly presenting pathology, known as lumbosacral plexopathy, cannot be understated. Given the similar clinical presentation of lumbar spine pathologies and lumbosacral plexopathies, it can be difficult to differentiate these two diagnoses in the clinical setting. Resultingly, the inappropriate diagnosis of either pathology can result in ineffective clinical management. Thus, this review aims to aid in the clinical differentiation between lumbar spine pathology and lumbosacral plexopathy. Specifically, this paper delves into spine and plexus anatomy, delineates the clinical assessment of both pathologies, and highlights powerful diagnostic tools in the hopes of bolstering appropriate diagnosis and treatment. Lastly, this review will describe emerging treatment options for both pathologies in the preclinical and clinical realms, with a special emphasis on regenerative nerve therapies.

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Full Endoscopic Surgery for Thoracic Pathology: Next Step after Mastering Lumbar and Cervical Endoscopic Spine Surgery?

Cited by 8 publications

References 23 publications

Fully endoscopic transforaminal discectomy for thoracolumbar junction disc herniation with or without calcification under general anesthesia: Technical notes and preliminary outcomes

Fully endoscopic transforaminal discectomy for thoracolumbar junction disc herniation with or without calcification under general anesthesia: Technical notes and preliminary outcomes

Surgical Technique of Central and Over-the-Top Full-Endoscopic Decompression of the Cervical Spine: A Technical Note

Differentiating Lumbar Spinal Etiology from Peripheral Plexopathies

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