Percutaneous Transpedicular Lumbar Endoscopy: A Case Report

Uniyal, Priyank; Choi, Gun; Khedkkar, Bhushan

doi:10.14444/3031

Cited by 21 publications

(22 citation statements)

References 13 publications

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“…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. 24 In fact, in mechanical study, the transforaminal approach produced wider decompression with less effect on stability than posterior foraminal decompression.…”

Section: ) Highly Migrated Disc Herniationmentioning

confidence: 86%

“…With modifications of the transforaminal approach, such as the mobile outside-in technique, 12 the transpedicular approach, 14 the foraminoplastic superior vertebral notch approach, 27 and The decision was made to perform right TELD L4/5 with the mobile outside-in technique, and postoperatively the patient's extensor hallucis longus strength recovered to motor grade 5. Panel A shows a sagittal view of a large sequestrated downward migrated central disc at L4/5.…”

Section: ) Highly Migrated Disc Herniationmentioning

confidence: 99%

“…Various techniques exploring this safe working zone were described, which can be largely summarized as the inside-out, outside-in with foraminoplasty, and mobile outsidein techniques [ 10 - 12 ]. Additional techniques for exploring space around the region involved partial resection of the pedicle and facet complex [ 13 ] or resection directly through the pedicle [ 14 , 15 ] to allow wider exploration of the spinal canal adjacent to the disc in cases of migrated disc herniation [ 16 , 17 ].…”

Section: Transforaminal Approach: Transforaminal Endoscopic Lumbar DImentioning

confidence: 99%

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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: 86%

Section: ) Highly Migrated Disc Herniationmentioning

confidence: 99%

Section: Transforaminal Approach: Transforaminal Endoscopic Lumbar DImentioning

confidence: 99%

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

Kim

Jang

2020

Neurospine

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“…Krzok et al [ 15 - 17 ] described transpedicular endoscopic surgery for highly superiorly and inferiorly migrated disc herniation and facet cysts [ 18 ]. Further case reports of Uniyal et al [ 19 ] and Quillo-Olvera et al [ 20 ] confirmed the successful use of this burr hole technique, which allows direct access to the sequestration behind the pedicle.…”

Section: Introductionmentioning

confidence: 84%

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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“…All these causes pressurize the nerve root which leads to the disease. The purpose of intervention in this disease is to decrease the pressure and tension applied on the nerve by removing the source of pressure [6][7][8][9][10][11][12]. The percutaneous foraminotomy introduced in this case report is a newly developed minimally invasive device that reduces pressure on the nerve root as well as the blood vessels in the neural canal.…”

Section: Discussionmentioning

confidence: 99%

Application of percutaneous foraminotomy with a specially designed drill tip for foraminal stenosis patient - A case report -

Choo

Sim

2018

Anesth Pain Med

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Degenerative diseases are rapidly increasing all over the world with the increase of the elderly population.Spinal stenosis is one of the common degenerative disease and various treatment methods have been applied to treat this disease and control the pain. Currently, diverse, non-operative interventions used for the treatment of spinal stenosis in addition to novel interventional techniques and tools are rapidly [1].These interventions are alternative methods to patients who are not responsive to conservative treatment like physical therapy, medications and epidural steroid injections. Furthermore, these can be useful treatment options to patients who refuse surgery.Leg pain while walking, which is relieved when the patient squats, sits, or rests, is a typical symptom of foraminal stenosis. This suggests that the pressure on the nerve root is an important factor of disease pathogenesis and that foraminal decompression is central to the treatment of foraminal steno-The purpose of this report is to introduce a new therapeutic intervention for foraminal stenosis-percutaneous foraminotomy with the use of the Claudicare system. Percutaneous foraminotomy is a procedure that indirectly decompresses the foramen, and is performed in the safe area inside the neural foramen, which is Kambin's triangle. CASE REPORTA 77-year-old 164 cm, 62 kg previously healthy Asian man This case report describes a new method of pain management intervention: percutaneous foraminotomy using the Claudicare system (Seawon Meditech, Korea). In this case, a 77-year-old Asian man visited the hospital with motor weakness in his left foot. He was diagnosed with L4-5 grade three foraminal stenosis using Magnetic Resonance Imaging on both sides. A left L4-5 foraminal decompression was performed using percutaneous foraminotomy. The patient revisited the hospital after 17 months because the same symptoms recurred in his right foot. We observed that the symptoms on the left foot had disappeared completely. We confirmed the lesion on the right side and the postoperative change on the left side on the magnetic resonance imaging (MRI) image. Both the pre-and postoperative MRI images were compared by measuring the dimensions of the foraminal area (28.12 mm 2 vs. 38.58 mm 2 , repectively). T1W images showed signs of increased epidural soft tissue after percutaneous foraminotomy.

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Percutaneous Transpedicular Lumbar Endoscopy: A Case Report

Abstract: Authors found this technique very promising in complete removal of disc material under direct visualisation for high grade down disc herniations.

Cited by 21 publications

References 13 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

Application of percutaneous foraminotomy with a specially designed drill tip for foraminal stenosis patient - A case report -

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