Minimally invasive endoscopic spinal cord untethering: case report

Telfeian, Albert E.; Punsoni, Michael; Hofstetter, Christopher P.

doi:10.21037/jss.2017.06.10

Cited by 13 publications

(5 citation statements)

References 9 publications

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“…In the study of Potts et al, an average of 300 ml of bleeding was observed with open surgery (7). Significant blood loss and postoperative scarring are also associated with the muscle dissection in this approach (7,11). In our study, patients average blood loss was 30 ml.…”

Section: █ Discussionsupporting

confidence: 48%

Endoscopic untethering of tight filum terminale: an operative technique

Okay

Dalgıç²,

Yıldırım³

et al. 2020

Turkish Neurosurgery

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AIM: To demonstrate the various technical advantages of minimally invasive endoscopic untethering of tight filum terminale for the treatment of tethered cord syndrome (TCS). MATERIAL and METHODS: In five pediatric cases of TCS, we performed untethering by using the endoscopic technique. The age of the patients were 6, 7, 8, 9, and 12 years old. We used a nasal speculum of the transsphenoidal approach during the endoscopic surgical procedure. RESULTS: All the procedures were performed uneventfully, except for one case with a split cord malformation that showed neurologic deterioration caused by excision of the diastematomyelic fibrous septum at the thoracic level (unrelated to the endoscopic procedure at the L5-S1 level). This patient was referred to a rehabilitation clinic 5 days after surgery and showed significant improvement by the third postoperative month. The other four patients were discharged 1 day after the operation. CONCLUSION: Endoscopic release of filum terminale is a safe technique especially if it is performed with neuromonitoring. This technique may shorten the length of hospital stay and reduce perioperative blood loss. However, futher studies with a larger number of patients and long-term follow-up are needed.

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Section: █ Discussionsupporting

confidence: 48%

Endoscopic untethering of tight filum terminale: an operative technique

Okay

Dalgıç²,

Yıldırım³

et al. 2020

Turkish Neurosurgery

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“…In this video article, we will examine a case of tethered cord release using a minimally invasive spinal surgery technique called biportal endoscopic approach, 1 which has become increasingly popular in recent years. [2][3][4][5][6][7][8][9] 0:34 Case Presentation. Our patient is a 24-year-old female who has been experiencing severe back pain radiating to the buttocks with episodic attacks for the past 8 years.…”

Section: Transcriptmentioning

confidence: 99%

Surgical management of tethered spinal cord syndrome through biportal endoscopic approach: a novel technical note

Özer,

Ezgü,

Kaplan

et al. 2024

Neurosurgical Focus: Video

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This video article explores a case of tethered cord release through a minimally invasive biportal endoscopic approach. A 24-year-old female with chronic back pain and thigh numbness underwent surgery. The chosen approach involved biportal endoscopic technique, demonstrating precision with minimal bone excision. Preoperative imaging revealed a midline fusion defect at L5 and abnormal conus medullaris termination. The surgical procedure involved one-sided hemilaminectomy, durotomy, and careful filum terminale separation. Postoperatively, radiological exams confirmed success with minimal bone defect. Emphasizing minimal invasiveness, reduced bone excision, and muscle sparing, this technique showcased successful outcomes, enabling the patient’s rapid postoperative recovery without complications. The video can be found here: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23228

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“…As endoscopic spine surgery continues to enjoy wider adoption, spine surgeons are expanding potential indications for use of this technology. Numerous case series have shown potential applications in patients with complex pathology including burst fractures (113), BMP related heterotopic ossification (114,115), synovial cysts (116,117), migrated hardware (115), discitis (118), spinal cord untethering (119), and tumors (120) (Figure 8). While direct comparisons to more traditional techniques for these complex scenarios is limited, current available evidence highlights the versatility of endoscopic spine surgery in achieving favorable outcome with minimal morbidity.…”

Section: Revision Surgery and Previous Arthrodesismentioning

confidence: 99%

The benefit zone of full-endoscopic spine surgery

Hasan¹,

Härtl²,

Hofstetter³

2019

J Spine Surg

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Minimally invasive spine procedures have undergone rapid development during the last decade. Efforts to decrease muscle crush injuries during prolonged retraction, avoid significant soft tissue stripping and minimize bony resection are surgical principles that are employed to prevent iatrogenic instability and provide patients with decreased post-operative pain and disability. Full-endoscopic spine surgery represents a tool for the spine surgeon to provide targeted access to spinal pathology utilizing these principles. Endoscopic techniques have seen over 30 years of evolution and innovation, however, early iterations of these techniques largely focused on transforaminal lumbar microdiscectomies. Currently, endoscopic techniques are utilized for approaching pathology in the cervical, thoracic and lumbar spine. There has been a growing body of literature that not only confirms the efficacy of these procedures but also underscores the advantages these procedures offer with respect to less morbidity and safer complication profiles. Endoscopic decompressions have been utilized in the settings of degenerative spinal stenosis, spondylolisthesis, scoliosis, previous fusion, tumor and infection. Furthermore, endoscopic interbody fusion has also been utilized in the lumbar spine as technology continues to advance. As technological innovation continues to facilitate reproducible surgical technique and expand the indications for use, we believe that endoscopic spine surgical techniques will provide surgeons with a more powerful and less morbid approach to spinal pathology that ultimately elevates the standard of care when treating our patients. We present a brief review of the history of endoscopic spine surgery, an overview of current techniques and review current outcomes of endoscopic spine surgical procedures in the context of an invasiveness/complexity index to elucidate the benefit zone of these newer techniques.

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Minimally invasive endoscopic spinal cord untethering: case report

Cited by 13 publications

References 9 publications

Endoscopic untethering of tight filum terminale: an operative technique

Endoscopic untethering of tight filum terminale: an operative technique

Surgical management of tethered spinal cord syndrome through biportal endoscopic approach: a novel technical note

The benefit zone of full-endoscopic spine surgery

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