How I do it: percutaneous transforaminal endoscopic discectomy for lumbar disk herniation

Depauw, P.R.A.M.; Gadjradj, Pravesh S.; Hoeve, John S. Soria van; Harhangi, Biswadjiet S.

doi:10.1007/s00701-018-3723-5

Cited by 18 publications

(22 citation statements)

References 8 publications

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“…The results we have described showed that PTED was associated with less blood loss, shorter incisions, and shorter hospital stays than fenestration. The postoperative advantages of PTED that we observed are in keeping with other reports [ 16 , 18 ]. For elderly patients, a minimally invasive technique for DLSS that results in fewer iatrogenic injuries may result in faster recovery and easer rehabilitation [ 19 ].…”

Section: Discussionsupporting

confidence: 92%

Comparison Between Percutaneous Transforaminal Endoscopic Discectomy and Fenestration in the Treatment of Degenerative Lumbar Spinal Stenosis

Zhang¹,

Zhu²,

Zhou³

et al. 2020

Med Sci Monit

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Background This study aimed to investigate the therapeutic and prognostic effects of percutaneous transforaminal endoscopic decompression (PTED) for degenerative lumbar spinal stenosis (DLSS). Material/Methods One hundred eighty-eight patients with DLSS were randomly divided into the fenestration and the PTED group for decompression treatment. Operative time, incision length, amount of blood loss, length of hospitalization, and rates of complications in the 2 groups were compared. All patients underwent computed tomography (CT) scanning and magnetic resonance imaging (MRI) on the first postoperative day. All patients were assessed preoperatively and the treatment effects at 3, 6, and 12 months postoperatively were evaluated using visual analog scale (VAS), Japanese Orthopedic Association Score (JOA) and Oswestry Disability Index (ODI). The modified MacNab criteria were used to assess patient satisfaction 1 year after surgery at the last follow-up. Results Patients who underwent PTED had shorter incisions, less blood loss, and shorter hospital stays than those in the fenestration group, but operative times and complication rates were similar in the 2 groups. Moreover, CT scanning and MRI revealed similar treatment effects in the 2 groups. Compared with preoperative status, improvements in VAS, ODI, and JOA scores occurred at different times after surgery in the 2 groups. In particular, all 3 scores in the PTED group were higher than those in the fenestration group at 3 and 6 months postoperatively. There were no significant differences in MacNab scores between the 2 groups. Conclusions PTED is safer and more effective than traditional fenestration for management of DLSS.

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Section: Discussionsupporting

confidence: 92%

Comparison Between Percutaneous Transforaminal Endoscopic Discectomy and Fenestration in the Treatment of Degenerative Lumbar Spinal Stenosis

Zhang¹,

Zhu²,

Zhou³

et al. 2020

Med Sci Monit

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“…With the development of minimally invasive spinal surgery, percutaneous transforaminal endoscopic discectomy (PTED) has become a popular treatment for lumbar intervertebral disc herniation (8) due to its minimal invasiveness, more rapid recovery, and fewer complications (9,10). Posterolateral access can be utilized for a remedy if the procedure fails (11).…”

Section: Introductionmentioning

confidence: 99%

Epidural Anesthesia With Low Concentration Ropivacaine and Sufentanil for Percutaneous Transforaminal Endoscopic Discectomy: A Randomized Controlled Trial

Zhang

Chang

et al. 2020

Front. Med.

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Introduction: Percutaneous transforaminal endoscopic discectomy is a simple and effective treatment for lumbar intervertebral disc herniation, and local anesthesia is often applied in this kind of surgery in many developing countries, including China. However, many patients still feel excruciating pain under this condition. Epidural anesthesia with low-concentration ropivacaine has no impact on muscle strength, and patients might follow the surgeon well during operation. We hypothesize that epidural anesthesia is feasible for percutaneous transforaminal endoscopic discectomy. Methods: Two hundred patients with disc herniation who underwent percutaneous transforaminal endoscopic discectomy were randomized to receive either epidural anesthesia or local infiltration anesthesia. Primary outcome measures included the pain score, the cooperation degree, and patients' satisfaction. Mean arterial pressure and heart rate were also recorded. Results: Compared with the local anesthesia group, visual analog scale scores, mean arterial pressure, and heart rate were significantly lower in the epidural anesthesia group (P < 0.05), and patients' satisfaction was higher. There were no significant differences in the total operation time or blood loss between two groups. Conclusions: Epidural anesthesia with low-concentration ropivacaine and sufentanil is safe and effective for percutaneous transforaminal endoscopic discectomy.

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“…The Percutaneous Endoscopic Lumbar Discectomy can be safely performed through a transforaminal, an interlaminar, and a translaminar approach in most cases. There are different commercially available brands each with specific technical caveats 1,3) . The transforaminal approach through Kambin's Triangle is usually done accessing the disc directly.…”

Section: Discussionmentioning

confidence: 99%

Transforaminal Percutaneous Endoscopic Lumbar Discectomy Through a Transfacet Approach: Detailed Surgical Technique

Giacomini¹,

Todeschini²,

Miranda³

et al. 2021

J Minim Invasive Spine Surg Tech

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The percutaneous endoscopic lumbar discectomy (PELD) is a minimally invasive surgical approach described for the treatment of herniated lumbar disks. We aim to offer a brief anatomical review followed by a detailed and illustrated description of the transforaminal PELD technique using the Tom SHIDI endoscope and instrument set (MaxMoreSpine, Unterföhring, Germany). The transforaminal PELD through a transforaminal approach using Tom SHIDI allows safe surgical treatment of most lumbar hernias thanks to the posterior entrance into Kambin's Triangle through a bony landmark allowing foraminoplasty to be performed using a manual drill. Careful surgical technique minimizes unforeseen complications and makes this a safe and viable alternative to conventional microdiscectomy.

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How I do it: percutaneous transforaminal endoscopic discectomy for lumbar disk herniation

Cited by 18 publications

References 8 publications

Comparison Between Percutaneous Transforaminal Endoscopic Discectomy and Fenestration in the Treatment of Degenerative Lumbar Spinal Stenosis

Comparison Between Percutaneous Transforaminal Endoscopic Discectomy and Fenestration in the Treatment of Degenerative Lumbar Spinal Stenosis

Epidural Anesthesia With Low Concentration Ropivacaine and Sufentanil for Percutaneous Transforaminal Endoscopic Discectomy: A Randomized Controlled Trial

Transforaminal Percutaneous Endoscopic Lumbar Discectomy Through a Transfacet Approach: Detailed Surgical Technique

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