Biportal Endoscopic Spinal Surgery for Recurrent Lumbar Disc Herniations

Choi, Dae-Jung; Jung, Je-Tea; Lee, Sang-Jin; Kim, Young-Sang; Jang, Han-Jin; Yoo, Bang

doi:10.4055/cios.2016.8.3.325

Cited by 54 publications

(44 citation statements)

References 7 publications

(7 reference statements)

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“…Disc herniation can changes of the lumbar spine and lead to leg pain and associated clinical symptoms, with the potential to severely impair function and quality of life. [1,30,31] The rationale of management of disco genic pain must be based on accurate diagnosis, for lumbar nerve root pain radiates in the distribution of one or more dermatomes and may be associated with neurological deficits. [32,22,19,10] The painful condition of the disc is currently identified by preoperative diagnostic, and the endoscopic not only procedure in the big disc herniation with leg pain, but also the small disc herniation with sciatica may be considered.…”

Section: Discussionmentioning

confidence: 99%

“…With the development of minimally invasive endoscopic methods in spine surgery, a number of techniques have recently been developed that are applicable in the treatment of lumbar disc herniation. [1][2][3][4][5][6] The current trend of evolution lumbar spinal surgery has been toward endoscopic discectomy, which is a minimally invasive treatments aimed at removing nuclear material and decompression the nerve through devices were inserted percutaneous into intervertebral discs. [7,8] Endoscopic discectomy is a well-established technique for nerve decompression by transforaminal to access the disc space, and transforaminal endoscopic lumbar discectomy has become population for its advantages and matured with time.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Endoscopic transforaminal lumbar discectomy in the treatment of multilevel disc herniations

Yan¹,

Zhang²,

Zhang³

2019

Preprint

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“…Blood pressure and heart rate were stable, and arterial blood gas (ABG) test was performed every 1.5 hours. The final ABG analysis was carried out 30 minutes before turning the patient back to the supine position; the results indicated satisfactory results (pH, 7.42; PaCO 2 , 46 mmHg; PaO 2 , 300 mmHg; BE, 4.1 mmol/L; HCO 3 , 29 mmol/L; and SaO 2 , 99%). The patient had a 400-mL urinary output.…”

Section: Case Presentationmentioning

confidence: 99%

Bilateral Pulmonary Artery Embolism Following Posterior Spinal Surgery

Mottaghi¹,

Safari²,

Hallajnejad³

et al. 2017

Trauma Mon

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Introduction: Lumbar spine laminectomy and spinal fixation are common procedures, associated with several recognized complications. Thromboembolic events have been reported during these types of procedures; although their incidence is low, the associated mortality is not. Case Presentation: We present a 53-year-old woman with no medical history or risk factors for thromboembolic events, who underwent lumbar spine laminectomy and posterior spinal fixation. The clinical findings indicated the risk of pulmonary embolism following surgery, which was confirmed via capnography, arterial blood gas test, electrocardiography, and computed tomography angiography. Conclusions: Pulmonary embolism could be diagnosed, based on clinical findings and simple data provided by the analysis of vital signs and monitoring in the operating room.

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“… 8 9 10 11) Recently, studies on spinal surgery using the unilateral biportal endoscopic technique have been reported by several authors. 12 13 14) To date, few studies reported the results of over a year of follow-up after farlateral decompression using unilateral biportal endoscopic technique in foraminal stenosis. This study was to evaluate the clinical and radiological outcomes of far-lateral decompression using unilateral biportal technique.…”

mentioning

confidence: 99%

Clinical and Radiological Outcomes of Foraminal Decompression Using Unilateral Biportal Endoscopic Spine Surgery for Lumbar Foraminal Stenosis

Kim¹,

Choi²,

Park

2018

Clin Orthop Surg

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BackgroundSince open Wiltse approach allows limited visualization for foraminal stenosis leading to an incomplete decompression, we report the short-term clinical and radiological results of unilateral biportal endoscopic foraminal decompression using 0° or 30° endoscopy with better visualization.MethodsWe examined 31 patients that underwent surgery for neurological symptoms due to lumbar foraminal stenosis which was refractory to 6 weeks of conservative treatment. All 31 patients underwent unilateral biportal endoscopic far-lateral decompression (UBEFLD). One portal was used for viewing purpose, and the other was for surgical instruments. Unilateral foraminotomy was performed under guidance of 0° or 30° endoscopy. Clinical outcomes were analyzed using the modified Macnab criteria, Oswestry disability index, and visual analogue scale. Plain radiographs obtained preoperatively and 1 year postoperatively were compared to analyze the intervertebral angle (IVA), dynamic IVA, percentage of slip, dynamic percentage of slip (gap between the percentage of slip on flexion and extension views), slip angle, disc height index (DHI), and foraminal height index (FHI).ResultsThe IVA significantly increased from 6.24° ± 4.27° to 6.96° ± 3.58° at 1 year postoperatively (p = 0.306). The dynamic IVA slightly decreased from 6.27° ± 3.12° to 6.04° ± 2.41°, but the difference was not statistically significant (p = 0.375). The percentage of slip was 3.41% ± 5.24% preoperatively and 6.01% ± 1.43% at 1-year follow-up (p = 0.227), showing no significant difference. The preoperative dynamic percentage of slip was 2.90% ± 3.37%; at 1 year postoperatively, it was 3.13% ± 4.11% (p = 0.720), showing no significant difference. The DHI changed from 34.78% ± 9.54% preoperatively to 35.05% ± 8.83% postoperatively, which was not statistically significant (p = 0.837). In addition, the FHI slightly decreased from 55.15% ± 9.45% preoperatively to 54.56% ± 9.86% postoperatively, but the results were not statistically significant (p = 0.705).ConclusionsUBEFLD using endoscopy showed a satisfactory clinical outcome after 1-year follow-up and did not induce postoperative segmental spinal instability. It could be a feasible alternative to conventional open decompression or fusion surgery for lumbar foraminal stenosis.

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Biportal Endoscopic Spinal Surgery for Recurrent Lumbar Disc Herniations

Cited by 54 publications

References 7 publications

Endoscopic transforaminal lumbar discectomy in the treatment of multilevel disc herniations

Endoscopic transforaminal lumbar discectomy in the treatment of multilevel disc herniations

Bilateral Pulmonary Artery Embolism Following Posterior Spinal Surgery

Clinical and Radiological Outcomes of Foraminal Decompression Using Unilateral Biportal Endoscopic Spine Surgery for Lumbar Foraminal Stenosis

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