Percutaneous endoscopic lumbar discectomy for high-grade down-migrated disc using a trans-facet process and pedicle-complex approach: a technical case series

Hu, Qingfeng; Pan, Hao; Fang, Yi-You; Jia, Gao-Yong

doi:10.1007/s00586-017-5365-3

Cited by 25 publications

(21 citation statements)

References 31 publications

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“…Panel F shows an intraoperative view of decompression after complete discectomy; the epidural space is well decompressed with a pulsating traversing nerve root under irrigation fluid pressure. www.e-neurospine.org partial resection of the pedicle and facet complex, 13 other expanded applications for more complex discectomy procedures have been described. 12,14,[28][29][30][31] Controlled reaming of the superior vertebral notch or part of the pedicle did not seem to affect spinal stability and outcomes.…”

Section: ) Highly Migrated Disc Herniationmentioning

confidence: 99%

A Narrative Review of Development of Full-Endoscopic Lumbar Spine Surgery

Kim

Jang

2020

Neurospine

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In the first phase of development of lumbar endoscopic spine surgery, the focus was on removal of soft disc material through the working corridor of Kambin's triangle using transforaminal endoscopic lumbar discectomy. With the introduction of the interlaminar approach and increased interest from both industry and surgeons, there has been an exponential development of endoscopic surgical equipment and a corresponding expansion of endoscopic techniques. Endoscopic treatment strategies are applied to conditions ranging from contained prolapsed intervertebral discs to noncontained migrated herniated discs, hard calcified discs, spinal stenosis in the central or lateral recess and the foraminal and extraforaminal region, and other combinations of degenerative conditions requiring decompression or fusion surgery. The further expansion of endoscopic surgical management involving complicated spinal cases and the final quartet of trauma, infections, tumors, and possibly deformities could be the future stage of endoscopic spine surgery development. This article covers the full range of current treatment strategies and presents possible future developments of endoscopic spine surgery for the management of lumbar spinal conditions.

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Section: ) Highly Migrated Disc Herniationmentioning

confidence: 99%

A Narrative Review of Development of Full-Endoscopic Lumbar Spine Surgery

Kim

Jang

2020

Neurospine

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“…LDHs with low-grade migration were treated by TELD according to Ahn et al 24 and highly migrated LDHs by transpedicular endoscopic lumbar discectomy. 14,15 In the small group of 13 patients who underwent transpedicular endoscopic surgery, we found 1 case with incomplete removal of the sequestration; this patient needed transforaminal endoscopic revision surgery. Most patients were satisfied with the surgical outcomes (92.31% according to the MacNab criteria).…”

Section: Discussionmentioning

confidence: 95%

“…[4][5][6][7]9 For highly inferiorly and superiorly migrated disc herniation, this technique is challenging because of its extreme oblique approach. Hu et al 14 described a modification of the Hoogland technique involving partial transpedicular endoscopy. They used a reamer technique with an extreme oblique access.…”

Section: Introductionmentioning

confidence: 99%

Transforaminal Endoscopic Surgery: Outside-In Technique

Krzok¹

2020

Neurospine

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Transforaminal endoscopic lumbar discectomy (TELD) with the outside-in technique can be applied to nearly all cases of lumbar disc herniation (LDH), and transpedicular endoscopic lumbar discectomy can be used to treat highly migrated LDHs. The purpose of this study was to outline these 2 outside-in surgical techniques and to present their clinical outcomes. Between January 2018 and January 2019, a total of 137 patients underwent either transforaminal or transpedicular endoscopic lumbar discectomy. We performed TELD in 124 patients and transpedicular endoscopic lumbar discectomy in 13 cases. All surgical procedures were performed under conscious sedation. The patients' mean age was 51.3 years; 51 were women and 86 were men. The overall disc recurrence rate was 5.12%. Visual analogue scale scores decreased significantly in both groups. According to the MacNab criteria, good and excellent results were obtained in 92.74% of patients after transforaminal and in 92.30% of patients after transpedicular endoscopic LDH treatment. The results suggest that TELD with the outside-in technique can be effective for the treatment of most cases of LDH. Transpedicular endoscopic lumbar discectomy can be considered as an alternative treatment for highly migrated LDH.

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“…The entry point was generally 10 -13 cm from the midline, the skin is infiltrated with 1% lidocaine, and a long 18-gauge spinal needle was inserted from the entry point toward the midline, in the anterior-posterior view, under intermittent fluoroscopic guidance. [25,26] As usual, the discography was not performed. A guide wire was then inserted and a small skin incision made around it.…”

Section: Surgical Proceduresmentioning

confidence: 99%

Endoscopic transforaminal lumbar discectomy in the treatment of multilevel disc herniations

Yan¹,

Zhang²,

Zhang³

2019

Preprint

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Background There were no studies in literature of multiple level lumbar disc herniation treatment by endoscopic procedures. The purpose of this study was to evaluate the efficacy of endoscopic treatment multiple level lumbar disc herniation by compare to the one level disc herniation. Methods A total of 267 patients of lumbar disc herniation who had endoscopic surgery were categorized into three different groups depending on the level number of endoscopic procedures. 78 cases had one level procedure (OL group), 54 cases had couple level procedures (CL group), and 35 cases had triple level procedures (TL group). Endoscopic discectomy procedures was performed and the clinical outcomes were recorded. Results There was no intraoperative death in this series. The hospital day were no significant difference among three groups. The operational time and blood loss were biggest in triple levels procedures and lest in one level procedure. When take into the influence the numbers of disc herniation, there were no significant difference per level among three groups. The pain index and ODI score were better than preoperational in all patients, and there were no significant difference among three groups. The disk and foramen height, and lumbar lordosis were no significant difference compare to preoperative in all patients, and there were no significant difference among three groups. All patients achieved pain free accomplished all surgery procedures, no infection, and no dural tear of cerebrospinal fluid leakage complication. Conclusions Endoscopic lumbar discectomy was effective and safe procedures in the treatment of multilevel lumbar disc herniation.

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Percutaneous endoscopic lumbar discectomy for high-grade down-migrated disc using a trans-facet process and pedicle-complex approach: a technical case series

Abstract: PELD via a facet process and pedicle-complex approach may be an option for high-grade, down-migrated lumbar disc herniation with completely sequestrated nucleus pulposus.

Cited by 25 publications

References 31 publications

A Narrative Review of Development of Full-Endoscopic Lumbar Spine Surgery

A Narrative Review of Development of Full-Endoscopic Lumbar Spine Surgery

Transforaminal Endoscopic Surgery: Outside-In Technique

Endoscopic transforaminal lumbar discectomy in the treatment of multilevel disc herniations

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