scholarly journals Percutaneous transforaminal endoscopic discectomy in a nine-year-old patient with sciatica: case report, technical note and overview of the literature

2021 ◽  
Author(s):  
P. S. Gadjradj ◽  
B. S. Harhangi
Keyword(s):  
Pediatric Population ◽  
Technical Note ◽  
Disk Herniation ◽  
Lumbar Disk Herniation ◽  
Endoscopic Techniques ◽  
Lumbar Disk ◽  
Technical Report ◽  
Endoscopic Discectomy ◽  
Percutaneous Transforaminal Endoscopic Discectomy ◽  
Robust Evidence

AbstractPercutaneous transforaminal endoscopic discectomy (PTED) is an alternative procedure to open microdiscectomy (OM) to treat sciatica caused by lumbar disk herniation. Even though robust evidence comparing PTED with OM is lacking, PTED is becoming increasingly popular to treat spinal disorders. In this technical report, the surgical technique and outcomes of PTED in a 9-year-old patient are described. Furthermore, an overview of the literature on full-endoscopic techniques to treat sciatica is given, showing that PTED is feasible, safe and effective to treat lumbar disk herniation in the pediatric population.

Application of a Targeted and Quantificational Foraminoplasty Device in Percutaneous  Transforaminal Endoscopic Discectomy for L5-S1 Disc Herniation: Preliminary Clinical Outcomes

2021 ◽  
Author(s):  
Jinlong Liu ◽  
Junlong wu ◽  
Honglei Zhang ◽  
Rui Zuo ◽  
Jiabin Liu ◽  
...  
Keyword(s):  
Leg Pain ◽  
Fluoroscopy Time ◽  
Low Back ◽  
Disk Herniation ◽  
Lumbar Disk Herniation ◽  
Lumbar Disk ◽  
Vas Score ◽  
Endoscopic Discectomy ◽  
Percutaneous Transforaminal Endoscopic Discectomy

Abstract ObjectivePercutaneous transforaminal endoscopic discectomy (PTED) is minimally invasive and has been widely used to treat patients with lumbar disk herniation(LDH) due to its safety and efficiency. However, due to the unique anatomy of the L5-S1 level, the PTED procedure is often difficult to perform in the region. ZESSYS, a targeted and quantificational foraminoplasty device, may help to overcome these anatomical limitations. In this study, we assessed the efficiency and the short-term effects of PTED with ZESSY at the L5-S1 level.MethodsBetween January to August of 2018, Fifty-six patients with lumbar disk herniation at the single level of L5–S1 and underwent percutaneous transforaminal endoscopic discectomy were enrolled in this retrospective cohort study. They were segregated into the the TESSYS group and the ZESSYS group. The puncture time, foraminoplasty time, decompression time and fluoroscopy time evaluated for the operation efficiency. Clinical outcomes were assessed by visual analog scale(VAS) score and Oswestry Disability Index(ODI) score. The MacNab criteria were used to evaluate patient subjective satisfaction at 12-month follow-up postoperatively.ResultsThe average puncture time (5.29±2.05 minutes), foraminoplasty time (12.82±2.52 minutes) and fluoroscopy time (26.29±5.96 seconds) were all significantly shorter in the ZESSYS group than in the TESSYS group (average puncture time 8.07±3.13 minutes, p<0.01; foraminoplasty time, 17.18±2.92 minutes, p<0.01; fluoroscopy time, 34.73±6.86 seconds; p<0.01). No significant differences were observed between the 2 groups in the decompression time (p=0.057). The VAS score of low back pain and leg pain, as well as the ODI score, improved at all time points postoperatively compared with preoprative , in both the TESSYS group and the ZESSYS group (P < 0.05). There were no significant differences in the VAS score of low back pain, VAS score of leg pain, and ODI score between the TESSYS group and the ZESSYS group at the same time points (P > 0.05). According to the MacNab criteria, the excellent and good rate at 12-month follow-up postoperatively was 85.7% in the TESSYS group and 89.3% in the ZESSYS group (P > 0.05).ConclusionThe targeted and quantificational foraminoplasty device named ZESSYS was more efficient in the puncture and foraminoplasty procedures, effectively protecting the exiting nerve and minimizing the level of radiation exposure. The device is efficient and safe for PTED in treating lumbar disk herniation at the L5-S1 level.

scholarly journals How I do it: percutaneous transforaminal endoscopic discectomy for lumbar disk herniation

2018 ◽  
Vol 160 (12) ◽  
pp. 2473-2477 ◽  
Author(s):  
Paul R. A. M. Depauw ◽  
Pravesh S. Gadjradj ◽  
John S. Soria van Hoeve ◽  
Biswadjiet S. Harhangi
Keyword(s):  
Disk Herniation ◽  
Lumbar Disk Herniation ◽  
Lumbar Disk ◽  
Endoscopic Discectomy ◽  
Percutaneous Transforaminal Endoscopic Discectomy

scholarly journals Full Endoscopic Technique for High-Grade Up-Migrated Lumbar Disk Herniation via a Translaminar Keyhole Approach: Preliminary Series and Technical Note

2020 ◽  
Vol 81 (05) ◽  
pp. 379-386 ◽  
Author(s):  
Guang-Xun Lin ◽  
Cheul-Woong Park ◽  
Tsz-King Suen ◽  
Vit Kotheeranurak ◽  
Su-Gi Jun ◽  
...  
Keyword(s):  
Surgical Approach ◽  
Perioperative Complications ◽  
Technical Note ◽  
Endoscopic Technique ◽  
Leg Pain ◽  
High Grade ◽  
Disk Herniation ◽  
Lumbar Disk Herniation ◽  
Lumbar Disk ◽  
Translaminar Approach

Abstract Background and Study Aims Technically and anatomically, accessing a high-grade migrated lumbar disk herniation (LDH) using traditional full endoscopic lumbar diskectomy (FELD) approaches (either transforaminal or interlaminar) is challenging. The objective of this study was to present an effective and safe surgical approach for high-grade up-migrated LDH by translaminar FELD. Patients and Methods Thirteen patients with soft high-grade up-migrated LDH treated with a translaminar FELD between May 2015 and July 2018 were reviewed in this study. Five of these patients had very high-grade up-migration. Clinical outcomes were assessed including preoperative and postoperative visual analog scale (VAS) for back and leg pain, Oswestry Disability Index (ODI), and MacNab criteria. Results Overall, 7 of the 13 patients had disk-fragment migration at L4–L5: three at L5–S1, two at L3–L4, and the remaining one at L2–L3. In all cases, the highly up-migrated LDH was removed successfully through the translaminar approach, as confirmed by postoperative magnetic resonance imaging. The improvements of VAS for back and leg pain were 4.5 ± 0.9 to 1.3 ± 1.3 and 7.1 ± 1.0 to 1.6 ± 0.7, respectively (both p < 0.05). The ODI decreased from preoperative 41.9 ± 6.0 to postoperative 13.0 ± 4.1 (p < 0.05). According to the MacNab criteria, the satisfaction rate was 92.3% (excellent or good outcomes). None of the patients experienced any perioperative complications or recurrence during the follow-up period. Conclusion Although full endoscopic technique via the translaminar keyhole route may not be used as a routine surgical approach, it could serve as a feasible alternative method for patients with highly up-migrated disk herniation.

scholarly journals Micro-endoscopic discectomy versus percutaneous endoscopic surgery for lumbar disk herniation

2018 ◽  
Vol 46 (9) ◽  
pp. 3910-3917 ◽  
Author(s):  
Tuerhongjiang Abudurexiti ◽  
Ling Qi ◽  
Aikeremujiang Muheremu ◽  
Aierken Amudong
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Intraoperative Blood Loss ◽  
Disk Herniation ◽  
Total Hospital ◽  
Lumbar Disk Herniation ◽  
Lumbar Disk ◽  
Total Hospital Stay ◽  
Endoscopic Discectomy ◽  
Surgical Duration

Objective This study was performed to compare the effectiveness and safety of percutaneous endoscopic lumbar discectomy (PELD) versus micro-endoscopic discectomy (MED) in the treatment of patients with lumbar disk herniation. Methods In total, 216 patients treated for lumbar disk herniation in our center from January 2016 to July 2017 were prospectively divided into two groups according to the treatment received. One group was treated with PELD and the other group was treated with MED. The surgical duration, intraoperative blood loss, total hospital stay, visual analog scale (VAS) pain score, and Oswestry disability index (ODI) score before and after the surgery were compared between the groups. Results The surgical duration was significantly longer in the PELD than MED group. The intraoperative blood loss volume was significantly larger in the MED than PELD group. The total hospital stay was significantly longer in the MED than PELD group. The decline in the VAS pain score and increase in the ODI score after surgery were not significantly different between the two groups. Conclusions Although PELD is associated with a longer surgical duration than MED, it should still be considered superior to MED because of less intraoperative hemorrhage and a significantly shorter hospitalization time.

Biportal Endoscopic Lumbar Decompression for Lumbar Disk Herniation and Spinal Canal Stenosis: A Technical Note

2016 ◽  
Vol 78 (04) ◽  
pp. 390-396 ◽  
Author(s):  
Jin Eum ◽  
Sang Lee ◽  
Luigi Sabal ◽  
Sang Eun
Keyword(s):  
Spinal Canal ◽  
Technical Note ◽  
Disk Herniation ◽  
Lumbar Disk Herniation ◽  
Lumbar Disk ◽  
Lumbar Decompression ◽  
Canal Stenosis ◽  
Lumbar Disk Herniations ◽  
Lumbar Spinal

Background and Study Aims Endoscopic lumbar diskectomy through the interlaminar window is gaining recognition. Most of the literature describes these endoscopic procedures using specialized uniportal multichannel endoscopes. However, a single portal limits the motion of the instruments and obscures visualization of the operating field. To overcome this limitation, we propose a new technique that utilizes two portals to access the spinal canal. The biportal endoscopic lumbar decompression (BELD) technique uses two portals to treat difficult lumbar disk herniations and also lumbar spinal stenoses. Patients and Methods Seventeen patients were treated with BELD for 11 lumbar disk herniations and 6 lumbar spinal stenoses. Preoperative back and leg visual analog scale (VAS-B and VAS-L, respectively) scores and the Oswestry Disability Index (ODI) were recorded and compared with corresponding values on final follow-up. Results There was an average follow-up of 14 months. For the disk herniation group, preoperative VAS-L (7.8750 ± 1.24) and ODI (51.73 ± 18.57) was significantly different from follow-up postoperative VAS-L (0.87 ± 0.64, p = 0.000) and ODI (9.37 ± 4.83, p = 0.001). For the stenosis group, preoperative VAS-B (6.17 ± 1.94), VAS-L(7.83 ± 1.47), and ODI (63.27 ± 7.67) were significantly different from follow-up postoperative values (2.5 ± 1.04, p = 0.022; 2.00 ± 1.67, p = 0.001; 24.00 ± 6.45, p = 0.000, respectively). One patient underwent revision microdiskectomy for incomplete decompression. Conclusions BELD can achieve a similar decompression effect as microdiskectomy and unilateral laminotomy for bilateral decompression with a smaller incision than tubular diskectomy.

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