Double-Layer TachoSil Packing for Management of Incidental Durotomy During Percutaneous Stenoscopic Lumbar Decompression

Nam, Han Ga Wi; Kim, Hyung Suk; Park, Jin-Soo; Lee, Jaewoong; Park, Chun-Kun; Lim, Kang Taek

doi:10.1016/j.wneu.2018.09.040

Cited by 15 publications

(8 citation statements)

References 19 publications

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“…There are 2 approaches of performing endoscopic decompression of stenosis, one is the inside-out approach LE-ULBD or PSLD [ 27 ] which can address single or multiple level central and lateral stenosis with one incision. The other one is paraspinal approach (Para-PSLD) [ 28 ] which is a solution for foraminal and extraforaminal lesions. The term inside-out approach LE-ULBD can also be considered a translaminar approach in this study.…”

Section: Discussionmentioning

confidence: 99%

“…Lim et al [ 27 ] reported 1.9% (7 of 450 cases). They were managed accordingly with double layer TachoSil, haemostatic dura-sealant packing [ 28 ]. With this method, no reoperation was required for management of cerebrospinal fluid leak or root herniation.…”

Section: Discussionmentioning

confidence: 99%

“…A 9.5-mm outer diameter working sleeve was applied over the dilator which was subsequently removed once the sleeve was docked on the inferior border of the cranial hemilamina, A STENOSCOPE 28 (Techord, Daejeon, Korea), with a 8.4-mm outer diameter, 5.7-mm working channel, 120-mm working length and 12° angle optical lens endoscope was introduced into the working sleeve to start the endoscopic stage while on continuous saline irrigation using pump irrigation at 30-60 mmHg pressure.…”

Section: Skin Entry Point and Landing Sitementioning

confidence: 99%

“…They were managed accordingly with double layer TachoSil, haemostatic dura-sealant packing. 28 With this method, no reoperation was required for management of cerebrospinal fluid leak or root herniation. The 4 cases epidural hematoma were noted on the postoperative MRI and were followed clinically.…”

Section: Rationale Of the Inside-out Approachmentioning

confidence: 99%

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Inside-Out Approach of Lumbar Endoscopic Unilateral Laminotomy for Bilateral Decompression: A Detailed Technical Description, Rationale and Outcomes

Lim¹,

Meceda

Park³

2020

Neurospine

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Although lumbar stenosis was recognized as a contraindication for endoscopic spine surgery in the past, the advancement in endoscopic system design and development of approach techniques and strategies now enabled the endoscopic spine surgeons to manage all types of lumbar stenosis safely and more effectively. A full-endoscopic lumbar technique for surgical management of spinal canal stenosis is now used today in many advanced spine centers around the world as one of their standard procedures which can be done under general, regional, local anesthesia with sedation. In this technical report, we described in detail the inside-out approach of performing lumbar endoscopic unilateral laminotomy with bilateral decompression (LE-ULBD) and retrospectively reviewed hospital records of 127 patients who underwent the approach from December 2018 to March 2019 to address 1 level lumbar spinal stenosis and determined its outcome after 12-month follow-up period. Perioperative outcomes, operation time, length of hospital stay, and surgical complications were recorded and analyzed. The cross-sectional area of the thecal sac at the operated level was measured. The visual analogue scale (VAS) was assessed preoperatively, 1 month, and 12 months as well as the Oswestry Disability Index (ODI). The data were statistically analyzed (using SPSS ver. 17.0). The inside-out approach LE-ULBD was shown to effect statistically significant improvement in the VAS of leg and back pain as well as the ODI. It is a familiar, safe, and effective way of performing spinal stenosis decompression with good reproducible outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Skin Entry Point and Landing Sitementioning

confidence: 99%

Section: Rationale Of the Inside-out Approachmentioning

confidence: 99%

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Inside-Out Approach of Lumbar Endoscopic Unilateral Laminotomy for Bilateral Decompression: A Detailed Technical Description, Rationale and Outcomes

Lim¹,

Meceda

Park³

2020

Neurospine

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“…Recently, the use of a double layer of TachoSil 65 and suturing of the dura mater through the endoscope for incidental durotomy was described. 66…”

Section: Discussionmentioning

confidence: 99%

Comparative Study Between Uniportal Full-Endoscopic Interlaminar and Tubular Approach in the Treatment of Lumbar Spinal Stenosis: A Pilot Study

Carrascosa-Granada

Velazquez²,

Wagner

et al. 2020

Global Spine Journal

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Study Design: Multicenter, prospective, randomized, and double-blinded study. Objectives: To compare tubular and endoscopic interlaminar approach. Methods: Patients with lumbar spinal stenosis and neurogenic claudication of were randomized to tubular or endoscopic technique. Enrollment period was 12 months. Clinical follow up at 1, 3, 6 months after surgery with visual analogue scale (VAS), Oswestry Disability Index (ODI), and Japanese Orthopedic Association (JOA) score. Radiologic evaluation with magnetic resonance pre- and postsurgery. Results: Twenty patients were enrolled: 10 in tubular approach (12 levels) and 10 in endoscopic approach (11 levels). The percentage of enlargement of the spinal canal was higher in endoscopic approach (202%) compared with tubular approach (189%) but was not statistically significant ( P = .777). The enlargement of the dural sac was higher in endoscopic group (209%) compared with tubular group (203%) but no difference was found between the 2 groups ( P = .628). A modest significant correlation was found between the percentage of spinal canal decompression and enlargement of the dural sac ( r = 0.5, P = .023). Both groups reported a significant clinical improvement postsurgery. However, no significant association was found between the percentage of enlargement of the spinal canal or the dural sac and clinical improvement as determined by scales scores. Endoscopic group had lower intrasurgical bleeding ( P < .001) and lower disability at 6 months of follow-up than tubular group (p=0.037). Conclusions: In the treatment of lumbar spinal stenosis, endoscopic technique allows similar decompression of the spinal canal and the dural sac, lower intrasurgical bleeding, similar symptoms improvement, and lower disability at 6 months of follow-up, as compared with the tubular technique.

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How to Establish the Unilateral Biportal Endoscopic Surgery in the Surgeons’ Daily Practice

Suen

Yeung

2022

Unilateral Biportal Endoscopy of the Spine

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Double-Layer TachoSil Packing for Management of Incidental Durotomy During Percutaneous Stenoscopic Lumbar Decompression

Cited by 15 publications

References 19 publications

Inside-Out Approach of Lumbar Endoscopic Unilateral Laminotomy for Bilateral Decompression: A Detailed Technical Description, Rationale and Outcomes

Inside-Out Approach of Lumbar Endoscopic Unilateral Laminotomy for Bilateral Decompression: A Detailed Technical Description, Rationale and Outcomes

Comparative Study Between Uniportal Full-Endoscopic Interlaminar and Tubular Approach in the Treatment of Lumbar Spinal Stenosis: A Pilot Study

How to Establish the Unilateral Biportal Endoscopic Surgery in the Surgeons’ Daily Practice

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