Successful treatment of lumbar ligamentum flavum hematoma using a spinal full-endoscopic system

Abstract

Background: Percutaneous endoscopic lumbar discectomy (PELD) is a relatively less invasive treatment for lumbar disc herniation (LDH). This study investigated the usefulness of a full-endoscopic system for PELD in lumbar ligamentum flavum hematoma (LFH) treatment. Methods: Between May 2017 and Jun 2018, a total of five patients with leg pain due to LFH underwent surgery using a full-endoscopic system for PELD. A percutaneous endoscopic translaminar approach (PETA) was performed right above the LFH. Pathological examination of the hematoma capsule was performed in all cases. Results: The mean age of the patients was 64 years; there were 3 male and 2 female patients. Leg pain improved immediately after operation in all cases. Intraoperative findings and pathological examination revealed that the synovium at adjacent facet joints was not involved. Conclusions: Full-endoscopic system is not only a safe and effective minimally invasive system for the treatment of lumbar LFH, but is also superior to acquire a correct diagnosis.

Case of lumbar ligamentum flavum hematoma with epidural hematoma resulting in cauda equina compression

“…[1,2,8] In Kaneko et al 's report, five patients with LFH were successfully treated with endoscopic spine surgery; pathological evaluations revealed granulation tissue in all cases, but no evidence of synovial cysts. [5] Etiology of LFH Mechanical stress and angiogenesis both contribute to the development/progression of HLF and LFH [Figure 4a]. e resultant hemorrhages are typically attributed to arterial neovascularization arising from the dorsal muscular branches of the multifidus muscles, the posterior vertebral canal artery (prelaminar artery), or collapse/degeneration/hypertrophy of new small blood vessels within the HLF [9] [Figure 4b].…”

“…[ 1 , 2 , 8 ] In Kaneko et al .’s report, five patients with LFH were successfully treated with endoscopic spine surgery; pathological evaluations revealed granulation tissue in all cases, but no evidence of synovial cysts. [ 5 ]…”

Modified Interlaminar Endoscopic Lumbar Discectomy for Highly Upmigrated Disc Herniation: A Proctorship Description of the Technique via Translaminar Route

“…Recently this approach has been reported for different indications like the series of 5 patients of ligamentum flavum hematoma removed using the translaminar route. 28 The authors argued that the full-endoscopic translaminar route is not only safe and effective in cases of ligamentum flavum hematoma but also better to confirm the correct diagnosis as the continuity of the hematoma capsule and facet joint capsule is visible under high definition endoscopic view. The same author also reported a case on decompression of the L5-S1 foramen for a case of degenerative foraminal stenosis through the translaminar route.…”