Percutaneous Endoscopic Interlaminar Discectomy for Intracanalicular Disc Herniations At L5–S1 Using a Rigid Working Channel Endoscope

Choi, Gun; Lee, Sang-Ho; Raiturker, Pradyumna Pai; Lee, Seungcheol; Chae, Yu-Sik

doi:10.1227/01.neu.0000192713.95921.4a

Cited by 172 publications

(236 citation statements)

References 31 publications

(18 reference statements)

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“…Choi et al [22] recommended supervision by an experienced surgeon in the initial ten cases to overcome the learning curve for the interlaminar procedure at L5-S1. Surgeons should gain adequate experience by starting with simple cases first, in which no serious problems are anticipated from the anatomic conditions [6].…”

Section: Discussionmentioning

confidence: 99%

“…An advantage of percutaneous endoscopic lumbar discectomy is that local anesthesia can be used as was described by Choi et al [22]. The benefits of local anesthesia are reduced morbidity compared with general anesthesia and the ability of surgeons to continually communicate with the patient, thus avoiding the risk of nerve damage during insertion of the working sheath [20,22].…”

Section: Discussionmentioning

confidence: 99%

“…The benefits of local anesthesia are reduced morbidity compared with general anesthesia and the ability of surgeons to continually communicate with the patient, thus avoiding the risk of nerve damage during insertion of the working sheath [20,22]. However, the complications associated with local anesthesia in performing percutaneous endoscopic lumbar discectomy include posterior neck and thoracic back pain, headache, and even unconsciousness.…”

Section: Discussionmentioning

confidence: 99%

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Learning curve of full-endoscopic lumbar discectomy

et al. 2012

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Purpose To report the learning curve of full-endoscopic lumbar discectomy for a surgeon naive to endoscopic surgery but trained in open microdiscectomy. Methods From July 2006 to July 2009, 57 patients underwent full-endoscopic lumbar discectomy and 66 underwent open microdiscectomy. The clinical results were evaluated with a visual analog scale (VAS) and the Oswestry Disability Index (ODI). Spearman's coefficient of rank correlation (rho) was used to assess the learning curves for the transforaminal and interlaminar procedures of full-endoscopic lumbar discectomy. Results After full-endoscopic lumbar discectomy, the VAS and ODI results of the patients followed up were comparable with those of open microdiscectomy. A steep learning curve was observed for the transforaminal procedure, but not the interlaminar procedure. Conclusions The learning curve of the transforaminal approach was steep and easy to learn, while the learning curve of the interlaminar approach was flat and hard to master.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Learning curve of full-endoscopic lumbar discectomy

et al. 2012

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“…Choi et al contributed to the modification of endoscopic technique by access to the far lateral disc herniation, transiliac and interlaminar approach for difficult L5-S1 level disc herniations, approach for up migrated and down migrated disc herniations, transpedicular approach for high grade down migrated disc herniation and endoscopic treatment for lumbar spinal canal stenosis 1,15) .…”

Section: History Of Endoscopic Spine Surgerymentioning

confidence: 99%

Endoscopic Spine Surgery

Choi

Pophale

Patel

et al. 2018

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Surgical treatment of the degenerative disc disease has evolved from traditional open spine surgery to minimally invasive spine surgery including endoscopic spine surgery. Constant improvement in the imaging modality especially with introduction of the magnetic resonance imaging, it is possible to identify culprit degenerated disc segment and again with the discography it is possible to diagnose the pain generator and pathological degenerated disc very precisely and its treatment with minimally invasive approach. With improvements in the optics, high resolution camera, light source, high speed burr, irrigation pump etc, minimally invasive spine surgeries can be performed with various endoscopic techniques for lumbar, cervical and thoracic regions. Advantages of endoscopic spine surgeries are less tissue dissection and muscle trauma, reduced blood loss, less damage to the epidural blood supply and consequent epidural fibrosis and scarring, reduced hospital stay, early functional recovery and improvement in the quality of life & better cosmesis. With precise indication, proper diagnosis and good training, the endoscopic spine surgery can give equally good result as open spine surgery. Initially, endoscopic technique was restricted to the lumbar region but now it also can be used for cervical and thoracic disc herniations. Previously endoscopy was used for disc herniations which were contained without migration but now days it is used for highly up and down migrated disc herniations as well. Use of endoscopic technique in lumbar region was restricted to disc herniations but gradually it is also used for spinal canal stenosis and endoscopic assisted fusion surgeries. Endoscopic spine surgery can play important role in the treatment of adolescent disc herniations especially for the persons who engage in the competitive sports and the athletes where less tissue trauma, cosmesis and early functional recovery is desirable. From simple chemonucleolysis to current day endoscopic procedures the history of minimally invasive spine surgery is interesting. Appropriate indications, clear imaging prior to surgery and preplanning are keys to successful outcome. In this article basic procedures of percutaneous endoscopic lumbar discectomy through transforaminal and interlaminar routes, percutaneous endoscopic cervical discectomy, percutaneous endoscopic posterior cervical foraminotomy and percutaneous endoscopic thoracic discectomy are discussed.

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“…[2][3][4][5][6] This made the emergence of endoscopic transforaminal surgery for the treatment of lumbar disc herniation possible, which was followed by the development of many types of equipment and the improvement of the surgical technique. [7][8][9][10] Choi et al, 11 in 2006, reported the interlaminar approach between L5-S1 for intracanal disc herniation. The following year, a technique called directed extraforaminal fragmentectomy was introduced with a success rate of 92%.…”

Section: Introductionmentioning

confidence: 99%

Lumbar Endoscopic Percutaneous Discectomy - Clinical Outcome. Prospective Study

Sebben

Graells

Benato³

et al. 2017

Coluna/Columna

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Objective: Lumbar disc herniation is a common indication for surgical treatment of the spine. Open microdiscectomy is the gold standard. New surgical techniques have emerged, such as spinal endoscopy. We compared and evaluated two endoscopic techniques: the transforaminal and the interlaminar. Methods: Fifty-five patients underwent endoscopic technique and were assessed by VAS and ODI in the preoperative period, and in the first and sixth month after the procedure. Results: We had 89.1% of good results and 10.9% of complications. Conclusion: We conclude that endoscopic techniques are safe and effective for the surgical treatment of lumbar disc herniation.Keywords: Spine; Intervertebral disc displacement; Endoscopy. RESUMO Objetivo: A hérnia discal lombar é uma indicação comum de tratamento cirúrgico da coluna vertebral. A microdiscectomia aberta é o padrão de referência. Novas técnicas cirúrgicas têm surgido, como a endoscopia de coluna vertebral. Comparamos e avaliamos duas técnicas endos

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Percutaneous Endoscopic Interlaminar Discectomy for Intracanalicular Disc Herniations At L5–S1 Using a Rigid Working Channel Endoscope

Cited by 172 publications

References 31 publications

Learning curve of full-endoscopic lumbar discectomy

Learning curve of full-endoscopic lumbar discectomy

Endoscopic Spine Surgery

Lumbar Endoscopic Percutaneous Discectomy - Clinical Outcome. Prospective Study

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