The evolution of minimally invasive spine surgery

Yoon, Jang W.; Wang, Michael Y.

doi:10.3171/2018.11.spine181215

Cited by 39 publications

(23 citation statements)

References 78 publications

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“…Percutaneous and endoscopic minimally invasive surgeries have been rapidly evolving, 11,12 with the aim to provide lower complications rates while delivering comparable clinical outcomes and lower readmission rates, 13 reduced overall costs, 13-15 safety and efficacy even in risky populations, 16,17 and with the possibility to perform surgery under local anesthesia. 18,19 Reduced postoperative lumbar pain is attributed to the minimal lesion in healthy tissues, less bleeding, and the absence of muscle retraction in the ED.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Endoscopic Lumbar Discectomy Versus Microdiscectomy for the Treatment of Lumbar Disc Herniation: Pain, Disability, and Complication Rate—A Randomized Clinical Trial

et al. 2020

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Purpose: The objective was to compare the traditional microdiscectomy with percutaneous endoscopic lumbar discectomy for the treatment of disc herniations regarding pain, disability, and complications. Methods: Randomized clinical trial with 47 patients with disc herniations treated with 2 different surgical techniques: traditional microdiscectomy or percutaneous endoscopic lumbar discectomy. Forty-seven patients were divided into 2 groups and monitored for 12 months. Irradiated and low back pain were evaluated with the visual analog scale. Surgery complications were recorded. Results: After surgery, the sciatica and disability improved significantly but without significant differences between the groups. Improvements in back pain were significant until the third month. There were no statistical differences between groups regarding recurrence, infection, and the need for reoperation. Conclusions: Endoscopic discectomy results are similar to those of conventional microdiscectomy regarding pain and disability improvement. Postoperative lumbar pain is less intense with endoscopic discectomy than conventional microdiscectomy only during the first 3 months. Endoscopic discectomy is a safe and efficient alternative to microdiscectomy. Clinical Trials: Trial protocol registration number: RBR-5symrd (http://www.ensaiosclinicos.gov.br).

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Section: Discussionmentioning

confidence: 99%

Percutaneous Endoscopic Lumbar Discectomy Versus Microdiscectomy for the Treatment of Lumbar Disc Herniation: Pain, Disability, and Complication Rate—A Randomized Clinical Trial

et al. 2020

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“…[76] In examining this discrepancy between Asia and the US in the adoption of this technology, Yoon and Wang identified several key differences: 1) Lack of US billing codes supporting endoscopic surgery; 2) Poor reimbursement for endoscopic procedures; and 3) Lack of interest on the part of major US medical device manufacturers. [77] In the United States, in particular, there are strong fiscal incentives for surgeons to perform fusion procedures and utilize instrumentation due to the increased reimbursement associated with these types of procedures. Similarly, medical technology companies have clear recurring revenue streams that derive from the use of surgical implants (e.g.…”

Section: Current Trends In Spine Endoscopy Utilizationmentioning

confidence: 99%

Spinal endoscopy: evidence, techniques, global trends, and future projections

et al. 2022

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…Over the half past century, the field of spinal surgery has advanced significantly. In general, the trend is to minimize approach-related tissue trauma and, hence, reduce postoperative pain and disability [ 1 ]. Percutaneous endoscopic spine surgery corresponds to the trend.…”

Section: Introductionmentioning

confidence: 99%

A novel vertebral trench technique (VTT) involving transforaminal endoscopic lumbar foraminotomy (TELF) for very highly up-migrated lumbar disc herniation above L5

Jiang

et al. 2021

BMC Musculoskelet Disord

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Background Percutaneous endoscopic lumbar discectomy (PELD) has become popular for the treatment of symptomatic lumbar disc herniation (LDH). The very highly up-migrated lumbar disc herniation (VHUM-LDH) is difficult to remove under PELD. The purpose of this research is to investigate the feasibility, clinical efficacy and operative nuances of a novel VTT involving TELF for this type of herniation. Methods Eleven patients with very highly up-migrated LDH who underwent VTT involving TELF discectomy from May 2016 to May 2019 were included in this study. The operative time, length of hospital stay, and postoperative complications were recorded. Pre-and postoperative radiologic findings were investigated. All the patients were followed more than 1 year. The visual analogue score (VAS), Oswestry Disability Index (ODI), Japanese Orthopaedic Association (JOA) scores and modified MacNab criteria were used to assess surgical efficacy. Results All the 11 patients underwent successful surgery. We compared the VAS, ODI, and JOA scores before and after surgery. The differences were statistically significant (P < 0.05). According to the modified MacNab criteria, 10 patients were assessed as “excellent”, 1 patient was assessed as “good” at the last follow up. Conclusion The novel VTT involving TELF discectomy is a supplement to the traditional PELD. This technique enables the endoscope with working cannula to get closer the sequestrated nucleus pulposus without irritating the exiting nerve root, and facilitates the nucleus pulposus be removed successfully under direct visualization. The VTT involving TELF discectomy can be a safe, effective and feasible surgical procedure for the treatment of LDH with very highly up-migrated.

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The evolution of minimally invasive spine surgery

Cited by 39 publications

References 78 publications

Percutaneous Endoscopic Lumbar Discectomy Versus Microdiscectomy for the Treatment of Lumbar Disc Herniation: Pain, Disability, and Complication Rate—A Randomized Clinical Trial

Percutaneous Endoscopic Lumbar Discectomy Versus Microdiscectomy for the Treatment of Lumbar Disc Herniation: Pain, Disability, and Complication Rate—A Randomized Clinical Trial

Spinal endoscopy: evidence, techniques, global trends, and future projections

A novel vertebral trench technique (VTT) involving transforaminal endoscopic lumbar foraminotomy (TELF) for very highly up-migrated lumbar disc herniation above L5

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