19 Destandau’s Technique: Interlaminar Approach (Lumbar Diskectomy with Canal Decompression)

2018 ◽  
Keyword(s):  
Interlaminar Approach

scholarly journals Comparative Analysis of Non-Full and Full Endoscopic Spine Technique via Interlaminar Approach for the Treatment of Degenerative Lumbar Spinal Stenosis: A Retrospective, Single Institute, Propensity Score-Matched Study

2021 ◽  
pp. 219256822110391
Author(s):  
Qiang Jiang ◽  
Yu Ding ◽  
Zhengcao Lu ◽  
Hongpeng Cui ◽  
Jianjun Zhang ◽  
...  
Keyword(s):  
Propensity Score ◽  
Radiation Exposure ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Clinical Efficacy ◽  
Operation Time ◽  
Degenerative Lumbar Spinal Stenosis ◽  
Interlaminar Approach ◽  
Intraoperative Fluoroscopy ◽  
Lumbar Spinal

Study Design: Retrospective study. Objective: To compare the clinical efficacy of posterior lumbar laminectomy decompression under full endoscopic technique (Endo-LOVE) and percutaneous endoscopic medial foraminal decompression (PE-MFD) in the treatment of degenerative lumbar spinal stenosis (DLSS). Methods: Between April 2017 and April 2018, 96 patients with DLSS underwent Endo-LOVE or PE-MFD, including 58 with Endo-LOVE and 38 with PE-MFD. After propensity score matching (PSM), patient characteristics, operation time, intraoperative fluoroscopy times, postoperative bedridden time, hospital stay and postoperative complications were recorded and compared. The clinical efficacy was evaluated according to Oswestry disability index (ODI), visual analogue scale (VAS), lumbar disease JOA and modified MacNab criteria. Results: A total of 96 patients with DLSS were included in the study. After PSM, the 2 groups were comparable in patient demographic and baseline characteristics. The operation time and intraoperative fluoroscopy times in PE-MFD group were significantly more than those in Endo-LOVE group ( P < .05). The operation time in PE-MFD group was significantly less than that in Endo-LOVE group ( P < .05). The intraoperative fluoroscopy times in PE-MFD group were significantly more than that in Endo-LOVE group ( P < .05). The ODI, VAS and lumbar disease JOA in the 2 groups were significantly improved comparing with those before operation ( P < .05). According to the modified MacNab criteria, the excellent and good rates of the 2 groups were 93.5% in Endo-LOVE group and 87.1% in PE-MFD group ( P > .05). Conclusion: Endo-LOVE and PE-MFD technique can both effectively treat DLSS, and the short-term follow-up results are positive. Endo-LOVE technique has the advantages of fast puncture positioning, less radiation exposure and wider indications. However, PE-MFD needs more radiation exposure and has the possibility of incomplete decompression for complex multiplanar spinal stenosis.

Lumbar Epidural Contrast Spread Patterns for the Interlaminar Approach: Three-Dimensional Analysis Using Antero-Posterior, Lateral, and Contralateral Oblique Views

Pain Medicine ◽  
2019 ◽  
Vol 21 (4) ◽  
pp. 747-756
Author(s):  
Jatinder Gill ◽  
Thomas Simopoulos ◽  
Vwaire Orhurhu ◽  
Jyotsna Nagda ◽  
Moris Aner
Keyword(s):  
Facet Joint ◽  
Three Dimensional ◽  
Lateral View ◽  
Common Location ◽  
Three Dimensional Mapping ◽  
Interlaminar Approach ◽  
Median Volume ◽  
Multiple Variables ◽  
Dimensional Mapping ◽  
Consistent Location

Abstract Objective To describe and analyze lumbar epidural contrast spread patterns in antero-posterior (AP), lateral, and contralateral oblique (CLO) views. Methods Lumbar epidural contrast spread patterns after interlaminar injection were prospectively collected in AP, lateral, and several CLO views and analyzed for multiple variables; three-dimensional mapping was also performed. Results Epidural contrast patterns were prospectively analyzed in 28 subjects. The median volume of contrast injected was 2 mL; the AP view was more sensitive than the lateral view to detect foraminal uptake (13/28, 46%, 95% confidence interval [CI] = 27–66%, vs 7/28, 25%, 95% CI = 11–45% subjects). CLO view demonstrated the most consistent location for epidural contrast spread, with contrast contacting the ventral laminar margin in 28/28 (100%, 95% CI = 87–100%) patients. The most common location of contrast spread in the lateral view was at the facet joint lucency, with only 8/28 (29%, 95% CI = 13%–49%) subjects showing contrast contacting the spinolaminar junction. Lateral view was more sensitive than the CLO view in ventral epidural contrast spread detection. The extent and distribution of the spread did not bear any relationship to the volume injected or to the needle location in AP view. Conclusions CLO view provides the most consistent landmark for lumbar epidural contrast spread, and lateral view is most suited to confirming ventral epidural spread. The AP view may be the most optimal for determining target access when considering access to the dorsal root ganglia; in an individual patient, the volume injected and needle location in AP view do not reliably predict target access. The volume to be injected and the need to re-access or obtain multisite access must be prospectively determined, based upon observation of the spread.

Learning Curve of Full-Endoscopic Technique Through Interlaminar Approach for L5/S1 Disk Herniations

2014 ◽  
Vol 70 (2) ◽  
pp. 1069-1074 ◽  
Author(s):  
Haidong Xu ◽  
Xiaozhou Liu ◽  
Gang Liu ◽  
Jiangning Zhao ◽  
Qiang Fu ◽  
...  
Keyword(s):  
Learning Curve ◽  
Endoscopic Technique ◽  
Interlaminar Approach

Percutaneous Endoscopic Interlaminar Unilateral Ventral Dural Approach for Symptomatic Bilateral L5–S1 Herniated Nucleus Pulposus: Technical Note

2018 ◽  
Vol 79 (06) ◽  
pp. 518-523 ◽  
Author(s):  
Sung Choi ◽  
Nitin Adsul ◽  
Ki Kim ◽  
Jeong Kim ◽  
Sung Chung ◽  
...  
Keyword(s):  
Nucleus Pulposus ◽  
Lower Limb ◽  
Leg Pain ◽  
Limb Pain ◽  
Lumbar Disk Herniation ◽  
Interlaminar Approach ◽  
Lower Limb Pain ◽  
Bilateral Lower Limb ◽  
Herniated Nucleus Pulposus

Background Percutaneous endoscopic lumbar diskectomy is a good treatment modality for lumbar disk herniation. However, when a patient complains of bilateral lower limb radicular pain with severe disk protrusion at the L5–S1 level, the transforaminal approach is often unable to resolve both lesions owing to anatomical limitations. It is also very difficult to resolve both lesions in an ipsilateral direction using the percutaneous interlaminar approach. We report our surgical technique and clinical results using a ventral dural approach of percutaneous endoscopic interlaminar lumbar diskectomy for L5–S1 herniated nucleus pulposus (HNP) in patients with bilateral radiculopathy due to a severe disk protrusion. Methods Twenty-seven patients with severe L5–S1 HNP complaining of back pain and bilateral lower limb pain were included in the study. The unilateral ventral dural approach of percutaneous full endoscopic interlaminar lumbar diskectomy technique was used. The visual analog scale (VAS) and Macnab criteria were used for clinical evaluation. All assessments were completed 1 day before surgery, 1 week after surgery, 6 months after surgery, and at final follow-up after surgery. Results The mean preoperative back and leg pain VAS scores decreased from 5.67 ± 0.78 and 7.81 ± 0.83 to 2.44 ± 0.58 and 2.26 ± 0.53 at 1 week, 1.78 ± 0.51 and 1.52 ± 0.58 at 6 months, and 1.56 ± 0.70 and 1.67 ± 0.96, respectively, at the final follow-up after surgery. With respect to the Macnab criteria, 51.85% of the results were excellent, 44.44% were good, and 3.70% were fair. Four cases recurred: three patients underwent conservative treatment and one patient operated with percutaneous endoscopic interlaminar lumbar diskectomy. Conclusion According to the results of this study, the ventral dural approach of percutaneous full endoscopic interlaminar lumbar diskectomy in patients with L5–S1 HNP associated with bilateral lower limb pain due to a severely protruded HNP is a good option for a minimally invasive surgical approach.

Full Endoscopic Interlaminar Approach for Nerve Root Decompression of Sacral Metastatic Tumor

2018 ◽  
Vol 112 ◽  
pp. 57-63 ◽  
Author(s):  
Sheng-Hua Tsai ◽  
Hsuan-Han Wu ◽  
Chun-Yuan Cheng ◽  
Chien-Min Chen
Keyword(s):  
Nerve Root ◽  
Metastatic Tumor ◽  
Interlaminar Approach ◽  
Nerve Root Decompression
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