State-of-the-art transforaminal percutaneous endoscopic lumbar surgery under local anesthesia: Discectomy, foraminoplasty, and ventral facetectomy

Sairyo, Koichi; Chikawa, Takashi; Nagamachi, Akihiro

doi:10.1016/j.jos.2017.10.015

Cited by 153 publications

(130 citation statements)

References 26 publications

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“…Recently, FELD for LDH was introduced by Yeung and Tsou, 6) and is gaining popularity with expanding adaptation for canal and foraminal stenosis. 3) The concept of FELD is based on minimal tissue damage, while achieving a favorable clinical outcome comparable with conventional open surgery. 4,5) Patients are expected to have less back pain, shorter hospitalization, and a quicker return to daily activities compared with the conventional method.…”

Section: Discussionmentioning

confidence: 99%

Operating Costs of Full-endoscopic Lumbar Spine Surgery in Japan

Manabe

Tezuka

Yamashita

et al. 2020

Neurol. Med. Chir.(Tokyo)

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For full-endoscopic lumbar discectomy, operating costs are also important because expensive equipment are necessary. We surveyed the operating costs of surgical equipment necessary for full-endoscopic surgery together with surgical procedure reimbursement fees. A total of 295 cases of full-endoscopic surgery via a transforaminal approach were retrospectively analyzed. We calculated the frequency of damage and the unit purchase price of devices such as endoscopes, and surgical instruments such as grasping forceps for nucleotomy, high-speed drill bar, and bipolar forceps, and examined the operating costs in Japanese yen against the procedure fee per case. Endoscope breakage occurred seven times, and a payment of ¥760,000 was necessary for trade-in and purchase of a new endoscope. The total breakage number of grasping forceps was 58, and the purchase price per unit was ¥116,000. Therefore, a total of ¥12,020,000 was required for the 295 cases, and the calculated operating cost that accompanies equipment breakage was ¥40,000 per case. In addition, about ¥118,000 was required for disposable bipolar forceps and highspeed drill bar to be used intraoperatively for each case. Thus, for one case it is calculated that total ¥158,000 is utilized for equipment from the surgical reimbursement fee per case specified by the Japanese Ministry of Health being ¥303,900. Minimally invasive procedures provide great benefit to patients; however, the eventual contribution to hospital profits is small and may not be sufficient. To resolve this issue, the cost of surgical equipment should be lowered and/or the surgical reimbursement fee of the full-endoscopic surgery should be raised.

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Section: Discussionmentioning

confidence: 99%

Operating Costs of Full-endoscopic Lumbar Spine Surgery in Japan

Manabe

Tezuka

Yamashita

et al. 2020

Neurol. Med. Chir.(Tokyo)

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“…Yeung et al (25) reported the long-term clinical results and more than 80% would be excellent and good. Next, TF full-endoscopic lateral recess decompression (TE-LRD) was started (16,17,18,26,27,28). Ahn et al (26) followed 45 patients who had the TE-LRD for years and reported satisfactory clinical results more than 80%.…”

Section: Discussionmentioning

confidence: 99%

A novel surgical concept of transforaminal full-endoscopic lumbar undercutting laminectomy (TE-LUL) for central canal stenosis of the lumbar spine with local anesthesia : A case report and literature review

et al. 2019

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Full-endoscopic spinal surgery was first developed for the lumbar herniated nucleus pulposus. Mainly, there are two types in the full-endoscopic lumbar surgery : i.e., transforaminal (TF) and interlaminar approach. The surgery can be done under the local anesthesia for the TF approach ; therefore, we need to further develop the TF approach to variety of the spinal disorders. Recently, the TF full-endoscopic surgery has been applied for the spinal canal stenosis. First, transforaminal full-endoscopic lumbar foraminoplasty for the foraminal stenosis ; then, transforaminal lumbar lateral recess decompression for the lateral recess stenosis has been developed. Finally, we have developed the surgical technique to decompress the central stenosis via TF approach under the local anesthesia. Prior to initiate the clinical case, we have attempted the lumbar undercutting laminectomy using a fresh cadaveric spine. After we technically confirmed that the transforaminal full-endoscopic lumbar undercutting laminectomy (TE-LUL) is possible, we applied the technique to the patient whose lung capacity did not allow general anesthesia. The 72 years old female patient with central canal stenosis could be improved her left leg pain and muscle weakness after TE-LUL under the local anesthesia. In this paper, we introduce the surgical technique of the TE-LUL and discuss of the efficacy of the TE-LUL. J. Med. Invest. 66 : 224-229, August, 2019

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“…After the wound was rinsed, the fenestrated brous ring was repaired by electrocoagulation. The working cannula was then removed, and the incision was closed [13].…”

Section: Operative Techniquementioning

confidence: 99%

Comparison of Conventional Fenestration Discectomy with Transforaminal Endoscopic Lumbar Discectomy for Treating Lumbar Disc Herniation：Minimum 2-year Long-term Follow-up in 1,100 patients

Li¹,

Zhou

2020

Preprint

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Purpose: To compare the efficacy of conventional interlaminar fenestration discectomy (IFD) with transforaminal endoscopic lumbar discectomy (TELD) for treating lumbar disc herniation (LDH). Methods: The clinical data of 1,100 patients who had been diagnosed with LDH between January 2012 and December 2017 were retrospectively analysed. IFD was performed on 605 patients in Group A, whereas TELD was performed on 505 patients in Group B. The Oswestry Disability Index, Visual Analogue Scale for pain and modified MacNab criteria were used to evaluate the outcomes. The surgery duration, intraoperative blood loss, postoperative off-bed activity and postoperative length of hospital stay were recorded. Results: The follow-up period ranged from 24 to 60 months, with an average of 43 months. The excellent and good outcome rates were 93.5% in Group A and 92.6% in Group B. There was no significant difference in efficacy between the groups (P > 0.05). However, Group B had significantly less intraoperative blood loss and shorter bed rest duration and postoperative length of hospital stay than Group A (P < 0.05). There were two cases of postoperative recurrence in Group A and three in Group B. Conclusions: Although conventional IFD and TELD had similar levels of efficacy in treating LDH, TELD had several advantages. There was less intraoperative bleeding, shorter length of hospital stay and shorter bed rest duration. It can be considered a safe and effective surgical option for treating LDH.

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State-of-the-art transforaminal percutaneous endoscopic lumbar surgery under local anesthesia: Discectomy, foraminoplasty, and ventral facetectomy

Cited by 153 publications

References 26 publications

Operating Costs of Full-endoscopic Lumbar Spine Surgery in Japan

Operating Costs of Full-endoscopic Lumbar Spine Surgery in Japan

A novel surgical concept of transforaminal full-endoscopic lumbar undercutting laminectomy (TE-LUL) for central canal stenosis of the lumbar spine with local anesthesia : A case report and literature review

Comparison of Conventional Fenestration Discectomy with Transforaminal Endoscopic Lumbar Discectomy for Treating Lumbar Disc Herniation：Minimum 2-year Long-term Follow-up in 1,100 patients

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