Interlaminar endoscopic lateral recess decompression—surgical technique and early clinical results

Birjandian, Zeinab; Emerson, S M; Telfeian, Albert E.; Hofstetter, Christoph P.

doi:10.21037/jss.2017.06.08

Cited by 16 publications

(25 citation statements)

References 43 publications

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“…Previously, we have emphasized the significance of spinal full-endoscopic system not only for LDH, but also lumbar foraminal stenosis (8) and symptomatic discal pseudocysts (20). Other investigators have also reported the operative indication of this system for other spinal diseases, such as lateral recess stenosis (21) and lumbar aneurysmal bone cyst (22). In this report, we have also proved the significance of this system even for lumbar LFH.…”

Section: Discussionsupporting

confidence: 65%

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

Kaneko¹,

Oshima²,

Inoue³

et al. 2018

J Spine Surg

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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.

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Section: Discussionsupporting

confidence: 65%

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

Kaneko¹,

Oshima²,

Inoue³

et al. 2018

J Spine Surg

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“…The full-endoscopic ULBD technique has been previously described by the senior author. 9 Briefly, sequential dilators are used to create a tubular path in which a beveled working cannula is placed, followed by a working-channel spinal endoscope (iLESSYS Delta, Joimax, Vertebris stenosis, RIWOSpine). Under direct endoscopic visualization, a high-speed diamond burr is used to create an ipsilateral laminotomy extending to the base of the spinous process, exposing the ligamentum flavum.…”

Section: Surgical Techniquementioning

confidence: 99%

Comparison of full-endoscopic and minimally invasive decompression for lumbar spinal stenosis in the setting of degenerative scoliosis and spondylolisthesis

Hasan¹,

McGrath²,

Sen³

et al. 2019

Neurosurgical Focus

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OBJECTIVEThe management of lumbar spinal stenosis (LSS) with concurrent scoliosis and/or spondylolisthesis remains controversial. Full-endoscopic unilateral laminotomy for bilateral decompression (ULBD) facilitates neural decompression while preserving stabilizing osseoligamentous structures and may be uniquely suited for the treatment of LSS with concurrent mild to moderate degenerative deformity. The safety and efficacy of full-endoscopic versus minimally invasive surgery (MIS) ULBD in this patient population is studied here for the first time.METHODSA retrospective analysis of prospectively collected data was conducted on 45 consecutive LSS patients with concurrent scoliosis (≥ 10° coronal Cobb angle) and/or spondylolisthesis (≥ 3 mm). Patient demographics, operative details, complications, and imaging characteristics were reviewed. Outcomes were quantified using back and leg visual analog scale (VAS) scores and the Oswestry Disability Index (ODI) at 2 weeks, 3 months, and 1 year.RESULTSA total of 26 patients underwent full-endoscopic and 19 underwent MIS-ULBD with an average follow-up period of 12 months. The endoscopic cohort experienced a significantly shorter hospital length of stay (p = 0.014) and fewer adverse events (p = 0.010). Both cohorts experienced significant improvements in VAS and ODI scores at all time points (p < 0.001), but the endoscopic cohort demonstrated significantly better early ODI scores (p = 0.024).CONCLUSIONSEndoscopic and MIS-ULBD result in similar functional outcomes for LSS with mild to moderate deformity, while the endoscopic approach demonstrates a favorable rate of complications. Further studies are required to better delineate the characteristics of spinal deformities amenable to this approach and the durability of functional results.

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“…50 Endoscopic decompression has been developed as an extension of transforaminal and interlaminar discectomy. 4 A recent cadaveric study demonstrated that the transforaminal approach combined with an extensive foraminoplasty allowed access to the lateral recess both ventral and dorsal to the traversing nerve root. 85 Minimally invasive tubular decompression for lumbar spinal stenosis has demonstrated favorable reduction in Oswestry Disability Index and leg pain while maintaining a low complication profile.…”

Section: Lumbar Endoscopic Unilateral Laminotomy For Bilateral Decompmentioning

confidence: 99%

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

Hofstetter

Ahn

Choi

et al. 2020

Global Spine Journal

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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.

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Interlaminar endoscopic lateral recess decompression—surgical technique and early clinical results

Cited by 16 publications

References 43 publications

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

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

Comparison of full-endoscopic and minimally invasive decompression for lumbar spinal stenosis in the setting of degenerative scoliosis and spondylolisthesis

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

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