How I do it? Full endoscopic transforaminal approach for lumbar disc herniation that migrated bilaterally to four corners

Kim, Ji Yeon; Choi, Su Yong; Kim, Hyeun Sung; Jang, Il‐Tae

doi:10.1007/s00701-021-04760-z

Acta Neurochir

2021

DOI: 10.1007/s00701-021-04760-z

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How I do it? Full endoscopic transforaminal approach for lumbar disc herniation that migrated bilaterally to four corners

Ji Yeon Kim

Su Yong Choi

Hyeun Sung Kim

et al.

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2024

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Cited by 2 publications

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Full Endoscopic Bilateral Discectomy at L5/S1 Level

Liu

2024

Clinical Spine Surgery

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Study Design: Technical report. Objective: This report aimed to describe a 3-step unilateral uniportal interlaminar circum-dural approach for entire spinal canal inspection and bilateral discectomy at L5/S1 level. Summary of Background Data: Treatment of lumbar disc herniation with bilateral symptoms at L5/S1 level is complicated in full endoscopic surgeries. Unilateral interlaminar approaches have been used for bilateral discectomy at L5/S1 level through a uniportal ventral dural approach or a biportal dorsal dural approach. Despite the reporting of successful clinical outcomes, inspection and manipulation of the entire spinal canal via a unilateral approach remain challenging. Methods: The 3-step inspection of the entire spinal canal includes the ipsilateral side, the midline, and the contralateral side. Two typical cases are provided to further demonstrate the technique. In case 1, bilateral symptoms were caused by bilateral multifocal herniations. In case 2, bilateral symptoms were caused by a huge midline herniation. Results: The surgical purposes were achieved as intended in both of the 2 cases. The herniations were successfully removed and the pain was relieved immediately after surgery. Conclusions: As indicated by the preliminary application, the present technique, integrating the advantages of both the ventral and the dorsal dural approaches, is probably an ideal choice for bilateral discectomy at L5/S1 level.

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Full Endoscopic Bilateral Discectomy at L5/S1 Level

Liu

2024

Clinical Spine Surgery

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Application of 3D visualization virtual surgery system in percutaneous transforaminal endoscopic discectomy

Gong,

Zhang,

et al. 2024

Technology and Health Care

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Background Percutaneous transforaminal endoscopic discectomy (PTED) is an effective minimally invasive technique for treating lumbar disc herniation (LDH). However, precise channel establishment remains challenging. A three-dimensional visualization virtual surgery system (3DVVSS) is increasingly used in specific surgeries, yet its value in PTED remains uncertain. Objective To investigate the application of a 3DVVSS combined with a self-made intervertebral foramen positioning puncture device (IFPPD) in PTED for the treatment of LDH. Methods This study enrolled 120 LDH patients who underwent PTED between January 2021 and February 2022. Patients were randomly assigned to 3DVVSS combined with the IFPPD group (V group), and the traditional freehand methods group (T group). Hospitalization days, number of puncture attempts, fluoroscopy time, operation time, visual analog scale (VAS), Oswestry disability index (ODI), and complications were analyzed. Results All patients completed follow-up without serious complications. Hospitalization days between the two groups were comparable ( p > 0.05). However, the V group showed statistically significant advantages over the T group in puncture time, number of puncture attempts, fluoroscopy times, and operation time ( p < 0.05). All patients exhibited significant improvements in VAS and ODI compared to those of preoperation ( p < 0.05). Still, there was no significant difference in VAS and ODI between T and V groups ( p > 0.05). Conclusion 3DVVSS combined with IFPPD can significantly improve the successful puncture rate, and reduce the operation time and the fluoroscopy times, indicating its great potential in future clinical applications.

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How I do it? Full endoscopic transforaminal approach for lumbar disc herniation that migrated bilaterally to four corners

Cited by 2 publications

References 8 publications

Full Endoscopic Bilateral Discectomy at L5/S1 Level

Full Endoscopic Bilateral Discectomy at L5/S1 Level

Application of 3D visualization virtual surgery system in percutaneous transforaminal endoscopic discectomy

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