An evaluation of the learning curve for a complex surgical technique: the full endoscopic interlaminar approach for lumbar disc herniations

2011 ◽  
Vol 11 (2) ◽  
pp. 122-130 ◽  
Author(s):  
Bing Wang ◽  
Guohua Lü ◽  
Alpesh A. Patel ◽  
Peigen Ren ◽  
Ivan Cheng
Keyword(s):  
Surgical Technique ◽  
Learning Curve ◽  
Lumbar Disc ◽  
Interlaminar Approach ◽  
Disc Herniations

scholarly journals Early Postoperative Results after Removal of Cranially Migrated Lumbar Disc Prolapse: Retrospective Comparison of Three Different Surgical Strategies

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
C. Schulz ◽  
U. Kunz ◽  
U. M. Mauer ◽  
R. Mathieu
Keyword(s):  
Lumbar Disc ◽  
Leg Pain ◽  
Surgical Approaches ◽  
Postoperative Results ◽  
Retrospective Comparison ◽  
Interlaminar Approach ◽  
Disc Material ◽  
Disc Herniations ◽  
Group A ◽  
Group B

Background. To compare the early postoperative results of three surgical approaches to lumbar disc herniations that migrated cranially. Minimally invasive techniques such as the translaminar and endoscopic transforaminal approaches are utilized in patients with lumbar disc herniations to gain access to cranially located disc material and to avoid the potentially destabilizing resection of ligament and bone tissue, which is associated with an extended interlaminar approach.Methods. This retrospective study compares the postoperative pain and functional capacity levels of 69 patients who underwent an interlaminar (Group A,n=27), a translaminar (Group B,n=22), or an endoscopic transforaminal procedure (Group C,n=20).Results. Median VAS scores for leg pain decreased significantly from before to after surgery in all groups. Surgical revisions were required in thirteen cases (five in Group A, one in Group B, and seven in Group C;P=0.031). After six weeks, there were significant differences in back pain and functional outcome scores and in the results for the MacNab criteria but not in leg pain scores.Conclusions. The interlaminar and translaminar techniques were the safest and fastest ways of gaining access to cranially migrated disc material and the most effective approaches over a period of six weeks.

scholarly journals Learning Curve and Early Results of Interlaminar and Transforaminal Full-Endoscopic Resection of Lumbar Disc Herniations

Cureus ◽  
2020 ◽  
Author(s):  
Petr Zelenkov ◽  
Vyacheslav V Nazarov ◽  
Sergey Kisaryev ◽  
Leysan Pimenova ◽  
Bahrom A Zakirov ◽  
...  
Keyword(s):  
Learning Curve ◽  
Endoscopic Resection ◽  
Lumbar Disc ◽  
Early Results ◽  
Disc Herniations

scholarly journals Feasibility and surgical technique of percutaneous transforaminal discectomy for the treatment of lumbar disc herniation

2021 ◽  
Vol 29 (1) ◽  
pp. 85-95
Author(s):  
D. Ferdinandov
Keyword(s):  
Surgical Technique ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Early Discharge ◽  
Infectious Complications ◽  
Invasive Technique ◽  
Worst Case ◽  
Endoscopic Discectomy ◽  
Disc Herniations

Percutaneous transforaminal endoscopic discectomy (PTED) is an alternative minimally invasive technique for the treatment of lumbosacral radicular syndrome resulting from lumbar disc herniation. The latter is performed with the help of local anesthesia and sedation in an awake patient with the advantage of direct feedback. Access to the target is lateral and follows a safe trajectory through the Kambin triangle. The main advantages of this surgical technique are the possibility of early discharge within 2 hours after its completion, negligible blood loss, lower risk of infectious complications, convenience in patients with obesity, reduced risk of epidural fibrosis. There are currently no large randomized trials of good quality demonstrating the advantage of PTED over open interlaminar access established in practice. In the worst case, endoscopic discectomy is not known to pose additional risks to patients. The operative technique with a clinical case and a discussion about the applicability of the new approach for the treatment of lumbar disc herniations are presented.

scholarly journals Giant central lumbar disc herniations: a case for the transdural approach

2018 ◽  
Vol 100 (3) ◽  
pp. e53-e56 ◽  
Author(s):  
I Tulloch ◽  
MC Papadopoulos
Keyword(s):  
At Risk ◽  
Lumbar Spine ◽  
Surgical Technique ◽  
Surgical Approach ◽  
Lumbar Disc ◽  
Permanent Disability ◽  
Disc Protrusion ◽  
Disc Herniations ◽  
Pros And Cons ◽  
Transdural Approach

Giant central lumbar disc protrusions can pose a significant operative challenge. Clinically, these patients are at risk of permanent disability, due not only to preoperative neural compromise caused by the protrusion itself but also to the potential iatrogenic risks associated with the standard extradural microdiscectomy technique. This is the first report to date of a giant central L3/4 disc protrusion being successfully treated through a transdural microdiscectomy approach. Prior to this report, there have been just two cases describing its application in the lumbar spine. However, neither of these reports has described its use below the level of L2/3. We compare our surgical technique with these authors and discuss the pros and cons of this surgical approach relative to the standard extradural microdiscectomy technique. Overall, we have observed encouraging results from this approach and this report would support a role for further investigation into this rarely used technique.

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