How I do it? Transforaminal endoscopic decompression of intraspinal facet cyst

Kim, Hyeun Sung; Sharma, Sagar; Raorane, Harshavardhan Dilip

doi:10.1007/s00701-019-03995-1

Cited by 6 publications

(7 citation statements)

References 9 publications

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“…However, selected patients with a facet cyst causing lateral recess stenosis can be www.e-neurospine.org S23 treated with TELD with good clinical results, sparing excessive soft tissue injuries, reducing facet damage, and conserving spinal stability as compared to open posterior decompression. [48][49][50] Tumor debulking using the transforaminal approach has been described sparingly in the literature. The main application is for palliative relief of symptoms in patients who had a pathological tissue sample obtained previously with a primary tumor identified.…”

Section: ) Less Common Indications Of Transforaminal Endoscopic Techmentioning

confidence: 99%

“…Facet cyst is a common clinical entity that is traditionally decompressed via the posterior approach. However, selected patients with a facet cyst causing lateral recess stenosis can be treated with TELD with good clinical results, sparing excessive soft tissue injuries, reducing facet damage, and conserving spinal stability as compared to open posterior decompression [ 48 - 50 ]. Tumor debulking using the transforaminal approach has been described sparingly in the literature.…”

Section: Transforaminal Approach: Transforaminal Endoscopic Lumbar DImentioning

confidence: 99%

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A Narrative Review of Development of Full-Endoscopic Lumbar Spine Surgery

Kim

Jang

2020

Neurospine

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In the first phase of development of lumbar endoscopic spine surgery, the focus was on removal of soft disc material through the working corridor of Kambin's triangle using transforaminal endoscopic lumbar discectomy. With the introduction of the interlaminar approach and increased interest from both industry and surgeons, there has been an exponential development of endoscopic surgical equipment and a corresponding expansion of endoscopic techniques. Endoscopic treatment strategies are applied to conditions ranging from contained prolapsed intervertebral discs to noncontained migrated herniated discs, hard calcified discs, spinal stenosis in the central or lateral recess and the foraminal and extraforaminal region, and other combinations of degenerative conditions requiring decompression or fusion surgery. The further expansion of endoscopic surgical management involving complicated spinal cases and the final quartet of trauma, infections, tumors, and possibly deformities could be the future stage of endoscopic spine surgery development. This article covers the full range of current treatment strategies and presents possible future developments of endoscopic spine surgery for the management of lumbar spinal conditions.

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Section: ) Less Common Indications Of Transforaminal Endoscopic Techmentioning

confidence: 99%

Section: Transforaminal Approach: Transforaminal Endoscopic Lumbar DImentioning

confidence: 99%

A Narrative Review of Development of Full-Endoscopic Lumbar Spine Surgery

Kim

Jang

2020

Neurospine

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“…Percutaneous endoscopic technique provides a novel avenue for surgical intervention. A recent case series preliminarily elucidated the feasibility and effectiveness of this technique in the treatment of lumbar synovial cysts ( 15 , 16 ). Compared to open surgery, endoscopic techniques show compelling advantages in terms of prompt recovery, minimal structural disturbance, and cost-effectiveness ( 16 ).…”

Section: Discussionmentioning

confidence: 99%

“…A recent case series preliminarily elucidated the feasibility and effectiveness of this technique in the treatment of lumbar synovial cysts ( 15 , 16 ). Compared to open surgery, endoscopic techniques show compelling advantages in terms of prompt recovery, minimal structural disturbance, and cost-effectiveness ( 16 ). Technically, either the transforaminal or translaminar approach can be chosen.…”

Section: Discussionmentioning

confidence: 99%

A rare gas-containing lumbar synovial cyst treated by percutaneous transforaminal endoscopic cystectomy: A case report and literature review

et al. 2023

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Spinal synovial cysts are rare entities for which standard surgical strategies are inconsistent. Here, we present an uncommon intraspinal gas-containing synovial cyst treated by percutaneous transforaminal endoscopic cystectomy. A 52-year-old man presented with radicular pain and intermittent claudication that had persisted for one month. Computed tomography revealed an intraspinal cystic lesion anteromedial to the left L4-L5 articular joint and the center of the lesion manifested gas contents. A transforaminal endoscopic procedure was performed and confirmed as a safe and minimally invasive technique for gas-containing lumbar synovial cysts. It provides a valuable substitution and supplementation to open surgery.

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“…1 2 3 With the development of new and improved endoscopic optics, instrumentation such as endoscopic drills with customized forceps, and surgical techniques, the limitations of endoscopic spine surgery have significantly reduced, and thus the range of conditions that can be treated by endoscopic spine surgery has expanded. 4 5 6 7…”

Section: Introductionmentioning

confidence: 99%

Minimally Neural Retractive, Total Annular Resection, Transforaminal Endoscopic (TARTE) Approach for Severely Canal Compromising Lumbar Disk Herniation Accompanied by a Neurologic Deficit

Kim¹,

Kim

Lee³

et al. 2022

J Neurol Surg A Cent Eur Neurosurg

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Objective Treatment of severely canal compromising lumbar disk herniations (LDH), occupying more than 50% of the canal area, are associated with technical difficulty and worse outcomes. This study aimed to describe new techniques of transforaminal endoscopic lumbar diskectomy (TELD) with less neural retraction, and total annular resection for broad-based severely canal compromising disk herniation. We also evaluated the feasibility and safety of the techniques, and analyzed the clinical and radiologic outcomes of 32 patients presenting with neurologic deficits. Methods A retrospective cohort study was performed with 32 consecutive patients who underwent TELD for broad-based severely canal compromising LDH between January 2018 and January 2020. We removed the LDH using two novel techniques: (1) the “mobile outside-in” approach and total annular resection method and (2) internal decompression and subsequent pushdown method of the migrated fragment. The cross-sectional area (CSA) on magnetic resonance image was evaluated preoperatively and compared with the postoperative image within 7 days and between 6 months and 1 year. The visual analog scale (VAS) for back and leg pain, Oswestry disability index (ODI), MacNab's criteria, and motor power of the involved lower extremities were evaluated pre- and postoperatively. Results A total of 32 patients, with an average age of 37.5 years (range: 17–66), underwent surgery. The mean VAS score for back pain improved from 7.84 ± 1.02 to 1.31 ± 0.54 and the ODI score improved from 74.3 ± 7.82 to 20.4 ± 3.71 at final follow-up. According to MacNab's criteria, 23 patients had excellent and 9 patients had good outcomes at final follow-up. All patients operated on at the L4–L5 level had great toe/ankle dorsiflexion and/or ankle plantar flexion weakness; knee extension weakness was found at the L2–L3 and L3–L4 levels. Motor function improved significantly; the mean values and range preoperatively, and at 1 month, 3 months, and final follow-up, were 3.41 ± 0.95 (1–4), 4.56 ± 0.56 (3–5), 4.88 ± 0.34 (4–5), and 4.97 ± 0.18 (4–5), respectively (p < 0.001, at all follow-up). The mean values and range of the preserved CSA proportion, preoperatively and within 1 week after surgery, and at final follow-up were 34.9 ± 10.9 (15–61), 81.06 ± 10.24 (63–97), and 93.03 ± 5.37 (76–99), respectively (p < 0.001, at all follow-up). Conclusion The transforaminal endoscopic approach for broad-based severely canal compromising LDH can be considered a feasible surgical option for an experienced surgeon. With total annular resection and pushdown of migrated fragments, safe and complete removal of LDH was possible in patients with a neurologic deficit. Total annular resection may increase the overall but not the early recurrence rate.

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How I do it? Transforaminal endoscopic decompression of intraspinal facet cyst

Cited by 6 publications

References 9 publications

A Narrative Review of Development of Full-Endoscopic Lumbar Spine Surgery

A Narrative Review of Development of Full-Endoscopic Lumbar Spine Surgery

A rare gas-containing lumbar synovial cyst treated by percutaneous transforaminal endoscopic cystectomy: A case report and literature review

Minimally Neural Retractive, Total Annular Resection, Transforaminal Endoscopic (TARTE) Approach for Severely Canal Compromising Lumbar Disk Herniation Accompanied by a Neurologic Deficit

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