scholarly journals Short-term Results of Microendoscopic Muscle-preserving Interlaminar Decompression versus Spinal Process Splitting Laminectomy

2018 ◽  
Vol 79 (06) ◽  
pp. 511-517 ◽  
Author(s):  
Mitsunori Yoshimoto ◽  
Noriyuki Iesato ◽  
Yoshinori Terashima ◽  
Tsuneo Takebayashi ◽  
Toshihiko Yamashita ◽  
...  
Keyword(s):  
Blood Loss ◽  
Minimally Invasive ◽  
Clinical Results ◽  
Minimally Invasive Procedures ◽  
Invasive Procedures ◽  
Patient Satisfaction Score ◽  
Spinal Process ◽  
Significant Difference ◽  
Patient Reported ◽  
Time Required

Study Design A retrospective comparative study. Objective To compare retrospectively the clinical results and surgical invasiveness of two different types of minimally invasive surgery for lumbar spinal canal stenosis: microendoscopic muscle-preserving interlaminar decompression (ME-MILD) and spinal process splitting laminectomy (SPSL). Summary of Background Data ME-MILD and SPSL are minimally invasive procedures. However, the two procedures have not been compared in the literature. Materials and Methods We retrospectively enrolled patients who underwent ME-MILD or SPSL from 2011 to 2015. The surgical invasiveness of each technique was determined by evaluating the time required for the surgical procedure, amount of blood loss, serum creatine kinase (CK) levels on postoperative day (POD) 1, C-reactive protein (CRP) levels on POD 3 and 7, and the hospitalization. The clinical results were evaluated using the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire score, the Short Form (36) Health Survey patient-reported outcome score, the visual analog scale for pain, a patient satisfaction score, and the incidence of surgical complications. Results A total of 97 patients were evaluated: 58 patients underwent ME-MILD, and 39 patients underwent SPSL. No significant differences were observed in the clinical results between the two groups. Regarding surgical invasiveness, no significant difference was found in the amount of blood loss, levels of CK, hospitalization, or time required for the procedure. However, CRP levels were significantly lower in the ME-MILD group. Conclusions ME-MILD and SPSL are both minimally invasive procedures. In a comparison of these two procedures, CRP was significantly lower in the ME-MILD group.

Operative results and learning curve: microscope-assisted tubular microsurgery for 1- and 2-level discectomies and laminectomies

2008 ◽  
Vol 25 (2) ◽  
pp. E14 ◽  
Author(s):  
Karishma Parikh ◽  
Andre Tomasino ◽  
Jared Knopman ◽  
John Boockvar ◽  
Roger Härtl
Keyword(s):  
Blood Loss ◽  
Minimally Invasive ◽  
Learning Curve ◽  
Operating Time ◽  
Spinal Instrumentation ◽  
Minimally Invasive Procedures ◽  
Invasive Procedures ◽  
Spinal Disease ◽  
Operative Results ◽  
Scale Scores

Object The authors present their clinical results and the learning curve associated with the use of tubular retractors for 1- and 2-level lumbar microscope-assisted discectomies and laminectomies. Methods The study involves a retrospective and prospective analysis of 230 patients who underwent noninstrumented minimally invasive procedures for degenerative lumbar spinal disease between 2004 and 2007. Data on patient demographic characteristics and operative results, including length of stay, blood loss, operative times, and surgical complications were collected. Clinical outcomes were assessed based on pre- and postoperative Visual Analog Scale scores, Oswestry Disability Index values, and the Macnab outcome scale scores. Results The results showed characteristic differences in blood loss and operating times between 1- and 2-level procedures and between discectomies and laminectomies. A significant learning curve was seen by a decrease in operating time for 1- level discectomies and 2-level laminectomies. Major complications were not observed. Conclusions The use of tubular retractors for microsurgical decompression of degenerative spinal disease is a safe and effective treatment modality. As with other techniques, minimally invasive procedures are associated with a significant learning curve. As surgeons become more comfortable with the procedure, its applications can be expanded to include, for example, spinal instrumentation and deformity correction.

scholarly journals Minimally Traumatic Surgical Procedures in Periodontics: a Review

2015 ◽  
Vol 17 (1) ◽  
pp. 60
Author(s):  
Humberto Osvaldo Schwartz-Filho ◽  
William Cunha Brandt ◽  
Caio Vinicius Gonçalves Roman-Torres
Keyword(s):  
Minimally Invasive ◽  
Surgical Procedures ◽  
Successful Outcome ◽  
Minimally Invasive Procedures ◽  
Invasive Procedures ◽  
Periodontal Surgery ◽  
Surgical Access ◽  
Surgical Wounds ◽  
Significant Difference ◽  
Microsurgical Approach

<p>The concept of minimally invasive procedures can be extended to all fields of dentistry. Periodontics, in particular, has been reported as one of the areas with great benefits. This review aims to describe the use of minimally invasive procedures in periodontal surgery, its concepts, applications, and possible benefits from its use. For that, 682 articles published between 1950 and 2012 focused on minimally invasive periodontal surgery were evaluated. Of them, 669 studies did not describe clearly the procedures, and did not attend the inclusion criteria. The results showed that proper lighting promotes increased visual acuity during surgical procedures, favoring the precision associated with<br />microsurgical instruments specifically designed, allowing a more accurate manipulation of the soft and hard tissues. Surgical access avoids unnecessary tissues removal, optimizing the debridement, improving vascularisation, and therefore the possibility of obtaining primary healing of surgical wounds. The microsurgical approach can improve the predictability of different periodontal procedures, providing better results and cause less postoperative discomfort. However, few controlled methodologies on the use of instruments to promote minimally invasive procedures in periodontics have been found in literature. Therefore, studies are needed to determine whether microsurgical techniques can lead to a significant difference in the successful outcome. Most of the studies are based on observations and experiences of the authors, which clearly<br />show that there are advantages in having better lighting, better vision, and a more controlled and less traumatic technique.</p>

scholarly journals Microsurgical unilateral laminotomy for bilateral decompression of degenerative lumbar canal stenosis: a comparative study

2019 ◽  
Vol 55 (1) ◽  
Author(s):  
Mohamed I. Refaat ◽  
Amr K. Elsamman ◽  
Adham Rabea ◽  
Mohamed I. A. Hewaidy
Keyword(s):  
Patient Satisfaction ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Invasive Technique ◽  
Decompression Surgery ◽  
Microsurgical Decompression ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Abstract Background The quest for better patient outcomes is driving to the development of minimally invasive spine surgical techniques. There are several evidences on the use of microsurgical decompression surgery for degenerative lumbar spine stenosis; however, few of these studies compared their outcomes with the traditional laminectomy technique. Objectives The aim of our study was to compare outcomes following microsurgical decompression via unilateral laminotomy for bilateral decompression (ULBD) of the spinal canal to the standard open laminectomy for cases with lumbar spinal stenosis. Subjects and methods Cases were divided in two groups. Group (A) cases were operated by conventional full laminectomy; Group (B) cases were operated by (ULBD) technique. Results from both groups were compared regarding duration of surgery, blood loss, perioperative complication, and postoperative outcome and patient satisfaction. Results There was no statistically significant difference between both groups regarding the improvement of visual pain analogue, while improvement of neurogenic claudication outcome score was significant in group (B) than group (A). Seventy-three percent of group (A) cases and 80% of group (B) stated that surgery met their expectations and were satisfied from the outcome. Conclusion Comparing ULBD with traditional laminectomy showed the efficacy of the minimally invasive technique in obtaining good surgical outcome and patient satisfaction. There was no statistically significant difference between both groups regarding the occurrence of complications The ULBD technique was found to respect the posterior spinal integrity and musculature, accompanied with less blood loss, shorter hospital stays, and shorter recovery periods than the open laminectomy technique.

scholarly journals Treatment of thoracolumbar trauma by short-segment percutaneous transpedicular screw instrumentation: prospective comparative study with a minimum 2-year follow-up

2014 ◽  
Vol 20 (2) ◽  
pp. 150-156 ◽  
Author(s):  
Petr Vanek ◽  
Ondrej Bradac ◽  
Renata Konopkova ◽  
Patricia de Lacy ◽  
Jiri Lacman ◽  
...  
Keyword(s):  
Blood Loss ◽  
Minimally Invasive ◽  
Cobb Angle ◽  
Control Group ◽  
Working Ability ◽  
Short Segment ◽  
Transpedicular Screw ◽  
Significant Difference ◽  
Screw Group

Object The main aim of this study was to compare clinical and radiological outcomes after stabilization by a percutaneous transpedicular system and stabilization from the standard open approach for thoracolumbar spine injury. Methods Thirty-seven consecutive patients were enrolled in the study over a period of 16 months. Patients were included in the study if they experienced 1 thoracolumbar fracture (A3.1–A3.3, according to the AO/Magerl classification), had an absence of neurological deficits, had no other significant injuries, and were willing to participate. Eighteen patients were treated by short-segment, minimally invasive, percutaneous pedicle screw instrumentation. The control group was composed of 19 patients who were stabilized using a short-segment transpedicular construct, which was performed through a standard midline incision. The pain profile was assessed by a visual analog scale (VAS), and overall satisfaction by a simple 4-stage scale relating to performance of daily activities. Working ability and return to original occupation were also monitored. Radiographic follow-up was defined by the vertebral body index (VBI), vertebral body angle (VBA), and bisegmental Cobb angle. The accuracy of screw placement was examined using CT. Results The mean surgical duration in the percutaneous screw group was 53 ± 10 minutes, compared with 60 ± 9 minutes in the control group (p = 0.032). The percutaneous screw group had a significantly lower perioperative blood loss of 56 ± 17 ml, compared with 331 ± 149 ml in the control group (p < 0.001). Scores on the VAS in patients in the percutaneous screw group during the first 7 postoperative days were significantly lower than those in the control group (p < 0.001). There was no significant difference between groups in VBI, VBA, and Cobb angle values during follow-up. There was no significant difference in screw placement accuracy between the groups and no patients required surgical revision. There was no significant difference between groups in overall satisfaction at the 2-year follow-up (p = 0.402). Working ability was insignificantly better in the percutaneous screw group; previous working position was achieved in 17 patients in this group and in 12 cases in the control group (p = 0.088). Conclusions This study confirms that the percutaneous transpedicular screw technique represents a viable option in the treatment of preselected thoracolumbar fractures. A significant reduction in blood loss, postoperative pain, and surgical time were the main advantages associated with this minimally invasive technique. Clinical, functional, and radiological results were at least the same as those achieved using the open technique after a 2-year follow-up. The short-term benefits of the percutaneous transpedicular screw technique are apparent, and long-term results have to be studied in other well-designed studies evaluating the theoretical benefit of the percutaneous technique and assessing whether the results of the latter are as durable as the ones achieved by open surgery.

Treatment of varicocele with reference to age: a retrospective comparison of three minimally invasive procedures

2006 ◽  
Vol 21 (1) ◽  
pp. 61-65 ◽  
Author(s):  
S. Beutner ◽  
M. May ◽  
B. Hoschke ◽  
C. Helke ◽  
M. Lein ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Minimally Invasive Procedures ◽  
Invasive Procedures ◽  
Retrospective Comparison

The Radius Surgical System – A New Device for Complex Minimally Invasive Procedures in Urology?

2007 ◽  
Vol 51 (4) ◽  
pp. 1015-1022 ◽  
Author(s):  
Thomas Frede ◽  
Ahmed Hammady ◽  
Jan Klein ◽  
Dogu Teber ◽  
Noriyuki Inaki ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Minimally Invasive Procedures ◽  
Invasive Procedures ◽  
New Device ◽  
System A ◽  
Radius Surgical System ◽  
Surgical System

scholarly journals Intraoperative Nice knots assistance for reduction in displaced comminuted clavicle fractures

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Fangning Hu ◽  
Xi Liu ◽  
Fanxiao Liu ◽  
Honglei Jia ◽  
Xiaolong Lv ◽  
...  
Keyword(s):  
Blood Loss ◽  
Rating Scale ◽  
Clavicle Fracture ◽  
Operation Time ◽  
Clinical Results ◽  
Intraoperative Blood Loss ◽  
Traditional Group ◽  
Significant Difference ◽  
Clavicle Fractures ◽  
Displaced Clavicle Fracture

Abstract Purpose The Nice knots have been widely used in orthopedic surgeries to fix torn soft tissue and fracture in recent years. The study aims to investigate the clinical efficacy and prognosis of intraoperative and postoperative Nice Knots-assisted reduction in the treatment of displaced comminuted clavicle fracture. Methods From Jan 2014 to Dec 2019, 75 patients diagnosed with unilateral closed displaced comminuted clavicle fracture were treated with open reduction and internal fixation (ORIF) in this study. Nice knot group (the NK group) included 38 patients and the other 37 patients were in the traditional group (the TK group). The time of operation and the amount of bleeding during operation were recorded. Post-operative clinical outcomes and radiographic results were recorded and compared between these two groups. The Visual Analogue Scale (VAS), Neer score, Rating Scale of the American Shoulder and Elbow Surgeons, Constant-Murley score and complications such as infection, nonunion, implant loosening, fragment displacement and hardware pain were observed in the two groups. Results In the comparison between the two groups, there was no significant difference in age, sex, the cause of displaced clavicle fracture, and other basic information between the two groups. The operation time, intraoperative fluoroscopy time, and intraoperative blood loss were significantly reduced in the NK group (P < 0.01). There were 2 cases of plate fracture in the TK group. The follow-up results showed that there was no significant difference in VAS, Neer score, ASES, and Constant-Murley scores between the two groups. Conclusion The use of Nice knot, in comminuted and displaced clavicle fractures can reduce intraoperative blood loss, shorten operation time, facilitate intraoperative reduction, and achieve satisfactory postoperative clinical results. This study demonstrates that Nice knot is a simple, safe, practical and effective auxiliary reduction method.

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