AOSpine Consensus Paper on Nomenclature for Working-Channel Endoscopic Spinal Procedures

Abstract

Study Design: International consensus paper on a unified nomenclature for full-endoscopic spine surgery. Objectives: Minimally invasive endoscopic spinal procedures have undergone rapid development during the past decade. Evolution of working-channel endoscopes and surgical instruments as well as innovation in surgical techniques have expanded the types of spinal pathology that can be addressed. However, there is in the literature a heterogeneous nomenclature defining approach corridors and procedures, and this lack of common language has hampered communication between endoscopic spine surgeons, patients, hospitals, and insurance providers. Methods: The current report summarizes the nomenclature reported for working-channel endoscopic procedures that address cervical, thoracic, and lumbar spinal pathology. Results: We propose a uniform system that defines the working-channel endoscope (full-endoscopic), approach corridor (anterior, posterior, interlaminar, transforaminal), spinal segment (cervical, thoracic, lumbar), and procedure performed (eg, discectomy, foraminotomy). We suggest the following nomenclature for the most common full-endoscopic procedures: posterior endoscopic cervical foraminotomy (PECF), transforaminal endoscopic thoracic discectomy (TETD), transforaminal endoscopic lumbar discectomy (TELD), transforaminal lumbar foraminotomy (TELF), interlaminar endoscopic lumbar discectomy (IELD), interlaminar endoscopic lateral recess decompression (IE-LRD), and lumbar endoscopic unilateral laminotomy for bilateral decompression (LE-ULBD). Conclusions: We believe that it is critical to delineate a consensus nomenclature to facilitate uniformity of working-channel endoscopic procedures within academic scholarship. This will hopefully facilitate development, standardization of procedures, teaching, and widespread acceptance of full-endoscopic spinal procedures.

Functional outcomes of full-endoscopic spine surgery for high-grade migrated lumbar disc herniation: a prospective registry-based cohort study with more than 5 years of follow-up

“…Recently, the development of instruments and techniques has enabled the use of FELD to correct highgrade migrated lumbar discs. Many spine surgeons have developed novel techniques for managing high-grade migrated lumbar disc herniation by using FELD, including expanding the entry point of the transforaminal endoscopic lumbar discectomy (TELD) approach by using the foraminoplastic technique [4,[9][10][11], the transfacet process and pedicle-complex approach [12], two-level TELD [8], contralateral TELD [13], the suprapedicular approach [14], and the transpedicular approach [15,16]. Alternatively, surgeons may opt to use a technique involving the posterior route, including the translaminar approach [17,18], the interlaminar endoscopic lumbar discectomy (IELD) approach [19,20], or adjacent IELD [21], which are similar to open surgery.…”

Comparison of Clinical Outcomes Following Lumbar Endoscopic Unilateral Laminotomy Bilateral Decompression and Minimally Invasive Transforaminal Lumbar Interbody Fusion for One-Level Lumbar Spinal Stenosis With Degenerative Spondylolisthesis

“…Minimally invasive unilateral laminotomy bilateral decompression was performed to treat LSS with degenerative spondylolisthesis to minimize the injury to the paraspinal musculoligamentous structures (6). Lumbar endoscopic unilateral laminotomy bilateral decompression (LE-ULBD) has been used to treat LSS with degenerative spondylolisthesis to further minimize the injury to the paraspinal musculoligamentous structures in recent years (6,(13)(14)(15)(16)(17).…”

Historical aspects of video endoscopic surgery of the lumbar spine

“…В связи с этим назрела необходимость в создании международной классификации эндоскопических пособий на позвоночнике. В 2020 г. AOSpine предложила такую классификацию и утвердила номенклатуру чрескожных видеоэндоскопических операций на позвоночнике [102]. Но до настоящего времени в нее не включены методики лапаро-и торакоскопии, чрескожные эндоскопические стабилизирующие операции, а также лечебные и диагно-стические фиброэндоскопические пособия.…”