Microendoscopic Excision of C2 Osteoid Osteoma

Kulkarni, Arvind G; Dhruv, Abhilash; Bassi, Anupreet

doi:10.1097/brs.0b013e31829cbf5e

Cited by 12 publications

(10 citation statements)

References 15 publications

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“…(2003) modified the tubular retractors to include a microscope, which is termed “Micro Endoscopic Discectomy” (MED). The term is used interchangeably for describing the discectomy procedure utilizing tubular retractors either with an endoscope or a microscope 7. Recent prospective randomized control trials (RCTs) have found a benefit of surgery for patients when conservative therapies fail 891011.…”

Section: Introductionmentioning

confidence: 99%

Microendoscopic lumbar discectomy: Technique and results of 188 cases

Kulkarni

Bassi

Dhruv

2014

IJOO

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Background:Discectomy performed open or with an operating microscope remains the standard surgical management. Tubular retractor system is being increasingly used. Potential benefits include less muscle and local damage, better cosmesis, decreased pain and operative time and faster recovery after surgery. We have evaluated the outcome of micro endoscopic discectomy (MED) utilizing tubular retractors in terms of safety and efficacy of the technique.Materials and Methods:188 consecutive patients who underwent surgery for herniated disc using the tubular retractors between April 2007 and April 2012 are reported. All patients had a preoperative MRI (Magnetic Resonance Imaging) and were operated by a single surgeon with the METRx system (Medtronic, Sofamor-Danek, Memphis, TN) using 18 and 16 mm ports. All patients were mobilized as soon as pain subsided and discharged within 24-48 hours post surgery. The results were evaluated by using VAS (Visual Analog Scale 0-5) for back and leg pain and ODI (Oswestry Disability Index). Patients were followed up at intervals of 1 week, 6 weeks, 3 months, 6 months, 12 months and 2 years.Results:The mean age of patients was 46 years (range 16-78 years) and the sex ratio was 1.5 males to 1 female. The mean followup was 22 months (range 8-69 months). The mean VAS scale for leg pain improved from 4.14 to 0.76 (P < 0.05) and the mean VAS scale for back pain improved from 4.1 to 0.9 (P < 0.05). The mean ODI changed from 59.5 to 22.6 (P < 0.05). The mean operative time per level was about 50 minutes (range 20-90 minutes). Dural punctures occurred in 11 (5%) cases. Average blood loss was 30 ml (range 10-500 ml). A wrong level was identified and later corrected in a case of revision discectomy. Four patients with residual disc-herniation had revision MED and three patients with recurrent disc herniation later underwent fusion. One patient had wound infection which needed a debridement.Conclusion:MED for herniated discs effectively achieves the goals of surgery with minimal access. The advantages of the procedure are cosmesis, early postoperative recovery and minimal postoperative morbidity.

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Section: Introductionmentioning

confidence: 99%

Microendoscopic lumbar discectomy: Technique and results of 188 cases

Kulkarni

Bassi

Dhruv

2014

IJOO

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“…Neck pain was the most frequent symptom, which was present in up to 94% of cases and was associated with neck stiffness and functional torticollis in 4 (23.5%) and 5 (29.4%) cases, according to available data, respectively [ 1 , 2 , 3 , 5 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

Transnasal Endoscopic Approach for Osteoid Osteoma of the Odontoid Process in a Child: Technical Note and Systematic Review of the Literature

et al. 2022

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Osteoid osteoma (OO) is a primary benign tumor that accounts for up to 3% of all bone tumors. The cervical spine is less affected by OOs, and very few cases of C2 OOs have been reported in the literature, both in adults and children. Surgery may be required in case of functional torticollis, stiffness, and reduced range of motion (ROM) due to cervical OOs refractory to medical therapy. Several posterior and anterior surgical techniques have been described to remove C2 OOs. In particular, anterior approaches to the cervical spine represent the most used surgical route for treating C2 OOs. We describe the first case of OO of the odontoid process removed through a transnasal endoscopic approach with the aid of neuronavigation in a 6-year-old child. No intraoperative complications occurred, and the post-operative course was uneventful. The patient had immediate relief of neck pain and remained pain-free throughout the follow-up period, with complete functional recovery of the neck range of motion (ROM). In this case, based on the favorable anatomy, the transnasal endoscopic approach represented a valuable strategy for the complete removal of an anterior C2 OO without the need for further vertebral fixation since the preservation of ligaments and paravertebral soft tissue.

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“…Percutaneous radio-frequency thermal ablation and laser photocoagulation have been promoted as minimally invasive treatment options for spinal osteoid osteomas. However, thermal necrosis denying histologic verification of the specimens[13,14], risk of neurovascular injury [15], incomplete resection and recurrent symptoms necessitating reoperation are some of the problems with radio frequency ablation [16,17]. Intraoperative 3D navigation has been previously utilized for resection of osteoid osteomas and other bony lesions of extremities as well as spine [18–20].…”

Section: Discussionmentioning

confidence: 99%

Motion preservation surgery: excision of juxta C5–C6 intervertebral disc osteoid osteoma using 3D C-arm based navigation: technical report

Kulkarni

Patel

2018

SICOT-J

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Introduction: Precise targeted excision of the C5–C6 osteoid osteoma with placement of reference array on clavicle with minimal disturbance of anatomy and motion.Methods: A 20-year-old male presented with an osteoid osteoma in the superior end plate of the C6 vertebra abutting the spinal canal causing intractable pain. The authors curetted the nidus using a 3D C-arm-based intraoperative scan integrated with an optical navigation system through a minimal access anterior cervical exposure. The patient reference array was affixed to the left clavicle using a threaded pin.Results: The postoperative CT-scan revealed complete excision. Follow-up MRI and CT after 12 months revealed C5–C6 intervertebral disc to be intact without evidence of any tumor recurrence. VAS for neck pain improved from 8/10 to 2/10 immediately postoperatively and 0/10 at 1 year follow-up with no limitation of cervical movement. A motion segment was preserved with this technique.Conclusions: Navigation allowed safe curettage of the nidus with minimal disturbance to the anatomy and motion. The site of attachment of patient reference array on clavicle can be recommended as stable, meeting all the criteria for optimal accuracy and stability.

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Microendoscopic Excision of C2 Osteoid Osteoma

Cited by 12 publications

References 15 publications

Microendoscopic lumbar discectomy: Technique and results of 188 cases

Microendoscopic lumbar discectomy: Technique and results of 188 cases

Transnasal Endoscopic Approach for Osteoid Osteoma of the Odontoid Process in a Child: Technical Note and Systematic Review of the Literature

Motion preservation surgery: excision of juxta C5–C6 intervertebral disc osteoid osteoma using 3D C-arm based navigation: technical report

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