Percutaneous Endoscopic Approach for Highly Migrated Intracanal Disc Herniations by Foraminoplastic Technique Using Rigid Working Channel Endoscope

Choi, Gun; Lee, Sang-Ho; Lokhande, Pramod; Kong, Byoung Joon; Shim, Chan Shik; Jung, Byungjoo; Kim, Jin-Sung

doi:10.1097/brs.0b013e31817bfa1a

Cited by 233 publications

(222 citation statements)

References 54 publications

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“…In addition, there have been case reports of rare complications after lumbar discectomy, such as development of an arteriovenous fistula, major vessel injury, epidural fibrosis, ureteral injury, compartment syndrome with acute renal failure, iliac artery injury, intradural disc migration, bowel injury, septicemia, symptomatic pneumorachis, instrument failure, postoperative radicular neuroma, Ogilvie's syndrome, and reflex sympathetic dystrophy 3,4,10,12,13,[15][16][17]19,21,22,34,36,37,41,44,45,48,52) . In reports on cases subsequent to full endoscopic discectomy, published complications have included recurrent disc herniation on the same side, incomplete removal of a ruptured disc, infection, neuronal injury (including sensory changes), dural tears, vascular injury, psoas hematoma, and sympathetically mediated pain [6][7][8]11,14,[23][24][25][26][27]29,32,35,42,43,46,55) . In this study, symptomatic PP occurred in about 1% of patients after endoscopic discectomy and three cases treated by conservative manage showed decreased cyst size.…”

Section: Discussionmentioning

confidence: 99%

Symptomatic Post-Discectomy Pseudocyst after Endoscopic Lumbar Discectomy

Kang

Park

2011

J Korean Neurosurg Soc

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Objective : The objectives of this study were to determine the frequency of symptomatic postdiscectomy pseudocyst (PP) after endoscopic discectomy and to compare the results of surgical and conservative management of them. Methods : Initial study participants were 1,503 cases (1,406 patients) receiving endoscopic lumbar discectomy by 23-member board of neurosurgeons from March 2003 to October 2008. All patients' postoperative magnetic resonance imaging (MRI) scans were evaluated. On the postoperative MRI, cystic lesion of T2W high and T1W low at discectomy site was regarded as PP. Reviews of medical records and radiological findings were done. The PP patients were divided into two groups, surgical and conservative management by treatment modality after PP detection. We compared the results of the two groups using the visual analogue scale (VAS) for low back pain (LBP), VAS for leg pain (LP) and the Oswestry disability index (ODI). Results : Among 1,503 cases of all male soldiers, the MRIs showed that pseudocysts formed in 15 patients, about 1.0% of the initial cases. The mean postoperative interval from surgery to PP detection was 53.7 days. Interlaminar approach was correlated with PP formation compared with transforaminal approach (p=0.001). The mean VAS for LBP and LP in the surgical group improved from 6.5 and 4.8 to 2.0 and 2.3, respectively. The mean VAS for LBP and LP in the conservative group improved from 4.4 and 4.4 to 3.9 and 2.3, respectively. There was no difference in treatment outcome between surgical and conservative management of symptomatic PP. Conclusion : Although this study was done in limited environment, symptomatic PP was detected at two months' postoperative period in about 1% of cases. Interlaminar approach seems to be more related with PP compared with transforaminal approach.

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Section: Discussionmentioning

confidence: 99%

Symptomatic Post-Discectomy Pseudocyst after Endoscopic Lumbar Discectomy

Kang

Park

2011

J Korean Neurosurg Soc

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“…Also, there is no interference with the epidural venous system that may lead to chronic neural edema and fibrosis. [7,18,19] Percutaneous endoscopic transforaminal lumbar discectomy is a minimally invasive procedure that preserves the stabilizing elements of the spine and avoids epidural scar formation. [6,20] In this study, the displacement values measured under loading after PTED and on the intact spine were similar to each other.…”

Section: (A) (B) (D) (C)mentioning

confidence: 99%

“…Also, there is no interference with the epidural venous system that may lead to chronic neural edema and fibrosis. [7] Many authors think that the stability of spine is preserved because the anatomical components of the spine are not damaged after PTED. However, careful review of the literature revealed no adequate biomechanical study on PTED.…”

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confidence: 99%

Biomechanical comparison of intact lumbar lamb spine and endoscopic discectomized lamb spine

Karakaşlı

Yıldız

Kumtepe

et al. 2013

Eklem Hastalik Cerrahisi

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Amaç: Bu çalışmada minimal invaziv perkütan endoskopik diskektomi sonrası omurganın hareketli segmentinin biyomekanik değişiklikleri sağlam omurga ile karşılaştırıldı ve endoskopik diskektominin lomber kuzu omurgası üzerindeki etkileri araştırıldı. Gereç ve yöntemler: Bu çalışmada 10 adet taze donmuş kuzu omurgası kullanıldı. Her bir omurgaya L4-L5 seviyesinde perkütan endoskopik diskektomi yapıldı. Sağlam ve endoskopik diskektomi yapılmış omurgalar için biyomekanik test, aksiyel kompresyon test makinesi kullanılarak gerçekleştiril-di. Aksiyel kompresyon tüm örneklere 5 mm/dk yükleme hızı ile uygulandı. Her bir omurgaya, özel tasarlanmış bir aparatla, 8400 N/mm moment fleksiyon, ekstansiyon, sağa eğilme ve sola eğilme hareketlerinde uygulandı. Bulgular: Aksiyel kompresyon ve fleksiyon testlerinde yer değiştirme bulgularına göre örnekler daha stabildi. Diskektomi yapılmış omurgaların yer değiştirme değerleri, sağlam omurgaların değerlerine yakındı. Her iki grup karşı-laştırıldığında, sadece sola eğilme ön-arka kayma değerleri anlamlı idi (p≤0.05). Sonuç: Perkütan transforaminal endoskopik diskektominin, (PTED) biyomekanik ve klinik açıdan dezavantajı yoktur. Endoskopik diskektominin stabilite yönünden de herhangi bir dezavantajı yoktur. Yalnızca sola eğilmede öne arkaya kayma değerleri istatistiksel olarak anlamlı bulundu. Bu sonuçların nedenini tüm omurgaların sol taraftan PTED yapılmış olmasına bağlamaktayız.Anahtar sözcükler: Biyomekanik; endoskopik diskektomi; sağlam omurga.Objectives: This study aims to perform a biomechanical comparison of changes on motion segments after minimally invasive percutaneous endoscopically discectomized and intact spine and to investigate the effects of endoscopic discectomy on the lumbar spine of the lamb. Materials and methods: Ten fresh-frozen lamb spines were used in this study. Percutaneous endoscopic discectomy was performed on each spine at L4-L5 level. The biomechanical tests for both intact spine and endoscopically discectomized spine were performed by using axial compression testing machine. The axial compression was applied to all specimens with a loading speed of 5 mm/min. 8400 N/mm moment was applied to each specimen to achieve flexion and extension motions, right and left bending through a specially designed fixture. Results: In axial compression and flexion tests, the specimens were more stable based on displacement values. The displacement values of discected spines were closer to the values of intact specimens. Comparing both groups, only displacement values of the left-bending anteroposterior test were significant (p≤0.05). Conclusion: Percutaneous transforaminal endoscopic discectomy (PTED) has no biomechanical and clinical disadvantages. Endoscopic discectomy has also no stability disadvantages. Only anteroposterior displacement values of left bending test were statistically significant. We consider that the reason for such results were due to the fact that PTED was performed on the left side of all specimens.

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“…[ [22][23][24] In 2010, Choi et al [25] devised a new technique that approached the disc herniation through an interlaminar window. Dezawa and Sairyo [26] further evolved the procedure using a high-speed drill.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of full-endoscopic posterior cervical foraminotomy for cervical radiculopathy caused by bony stenosis of the intervertebral foramen

Ohmori¹,

Ono²,

Hori³

2017

MIS

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Aim: Full-endoscopic posterior cervical foraminotomy (FPCF) has been utilized to treat cervical lateral disc herniation and provided good surgical outcomes. The authors examined the superiority of FPCF in patients with spondylotic foraminal stenosis. Methods: Fifty-nine cases of FPCF were evaluated. Of the 59 patients, 34 had lateral disc herniation (group H) and 25 had spondylotic foraminal stenosis (group S). Operative time, complications, length of hospital stay, visual analog pain scale scores of neck and arm pain, and the amount of facet joint resection were compared between the groups. Results: The mean operative times were 96 min (group H) and 100 min (group S). The lengths of hospital stay were 3.0 days and 3.9 days, respectively. No significant differences were observed in pre-operative neck and arm pain between the groups. Average neck pain at the final follow-up was significantly less severe in group H (2.9) than in group S (12). However, postoperative arm pain was the same after surgery in both groups (14). In both groups, 52% of the facet joint was resected. Conclusion:The surgical outcome of FPCF in patients with spondylotic foraminal stenosis is equivalent to that in patients with lateral disc herniation. Key words:Full endoscopic surgery, cervical radiculopathy, foraminotomy, bony stenosis of the intervertebral foramen ABSTRACT Article history:

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Percutaneous Endoscopic Approach for Highly Migrated Intracanal Disc Herniations by Foraminoplastic Technique Using Rigid Working Channel Endoscope

Abstract: Foraminoplastic-PELD is safe and effective procedure for surgical treatment of soft migrated herniations. The results are comparable to results of open discectomy.

Cited by 233 publications

References 54 publications

Symptomatic Post-Discectomy Pseudocyst after Endoscopic Lumbar Discectomy

Symptomatic Post-Discectomy Pseudocyst after Endoscopic Lumbar Discectomy

Biomechanical comparison of intact lumbar lamb spine and endoscopic discectomized lamb spine

Outcomes of full-endoscopic posterior cervical foraminotomy for cervical radiculopathy caused by bony stenosis of the intervertebral foramen

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