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Lumbar endoscopic

Guoxin Fan, Chaobo Feng, Wangcheng Xie, Dongdong Wang, Fei Liu, Chun Yuan, Zhi Zhou, Shisheng He
Background: Percutaneous endoscopic transforaminal discectomy (PETD) is usually chosen for lumbar disc herniation due to its obvious advantages such as small incision and absence of nerve or muscular traction. However, learning PETD is a great challenge for inexperienced surgeons. Objective: The study aimed to investigate whether isocentric navigation would be beneficial in PETD training. Methods: A total of 117 inexperienced surgeons were trained with PETD at L2/3, L3/4, L4/5, and L5/S1 on the cadavers without (Group A n=58) or with (Group B n=59) isocentric navigation...
2018: BioMed Research International
R Sanjeevan, S Prabu, A Azizul, Y Abdul-Halim
Being a rare clinical entity, discal cyst presents indistinguishably from other causes of lower back pain and radiculopathy. It is an extremely rare pathology with unclear pathogenesis, indeterminate natural history with no consensus on the ideal management of the condition. We report a rare case of discal cyst in a patient who presented to our centre with localised low back pain and subsequently left sided radicular pain. With the aid of MRI and with clear surgical indication we proceeded with endoscopic removal of the cyst and intraoperatively confirmed its origin from the adjacent disc...
July 2018: Malaysian Orthopaedic Journal
Li-Jun Li, Feng Chang, Yong Hai, Jin-Cai Yang, Cheng Xu, Jie Yuan, Jiu-Qiang Sun, Qing-Hua Wang, Sheng-Qiang Ding
OBJECTIVE: To evaluate clinical effects of lumbar spinal stenosis by endoscopic transforaminal decompression, and to provide a theory basis for selection of surgical candidates. METHODS: From June 2014 to January 2016, clinical data of 87 patients with lumbar spinal stenosis were retrospectively analyzed, including 45 males and 42 females, aged from 25 to 81 years old with an average of 55.14 years old; 8 cases on L₃,₄, 61 cases on L₄,₅, 18 cases on L₅S₁...
July 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Tarek Y El Ahmadieh, Cody B Wolfe, Joyce Koueik, Bradley E Weprin, Bermans J Iskandar, Angela V Price
Neuroendoscopy has demonstrated safety and efficacy in the treatment of a host of pediatric neurosurgical pathologies. With the increase in its applicability, several associated complications have been described in the literature. A common practice in pediatric neurosurgery is the use of Gelfoam sponge pledget in the burr hole, followed by bone fragments and dust (obtained from the created burr hole), to cover the dural defect. This technique is used to enhance burr hole sealing and potentially prevent CSF leakage from the surgical site...
August 10, 2018: Journal of Neurosurgery. Pediatrics
Dehong Yang, Xiaoliang Wu, Minghui Zheng, Jixing Wang
OBJECTIVES: To introduce a modified percutaneous endoscopic lumbar discectomy (PELD) technique to remove extraforaminal disc herniation at L5/S1 segment, including the technical essentials and preliminary results. MATERIALS AND METHODS: The geometric parameters of the transverse process, facet joint and sacrum (TFS) space based on imaging examination were measured in 100 common patients. The technical essentials including working cannula placement and disc removing involved in the technique were described...
August 6, 2018: World Neurosurgery
Hyeun Sung Kim, Rabindra L Pradhan, Nitin Adsul, Jee-Soo Jang, Il-Tae Jang, Seong-Hoon Oh
BACKGROUND: Intradural disc herniation is a rare entity with less than 0.3-1% of all disc herniations and at an L2-L3 level even rarer. The dural defects repairs on ventral aspect are technically challenging and may not be possible after durotomy hence many authors have placed fascia, muscle, or plugging by the hemostatic material. The surgical treatment of intradural disc herniation is usually posterior open surgery with formal durotomy to remove the disc fragments with good to fair results while the poorer outcome in late-presenting cases...
August 6, 2018: World Neurosurgery
Lei Kong, Xi-Fu Shang, Wen-Zhi Zhang, Li-Qun Duan, Yang Yu, Wei-Jian Ni, Yan Huang
BACKGROUND: Sufficient decompression of the nerve root canal is still regarded as the method of choice when operating on patients with lumbar disc herniation (LDH) with lumbar lateral recess stenosis; however, tissue-sparing procedures are becoming more popular. Endoscopic techniques offer advantages and the benefits of rehabilitation, which have become the standard in many surgical operations when operating on the spine. A significant issue has been the upgrading of instruments to provide enough bone resection under continuous visual control...
August 3, 2018: Der Orthopäde
Kai-Uwe Lewandrowski
OBJECTIVE: To analyze the positive predictive value of diagnostic 1% lidocaine containing transforaminal epidural steroid injections (TESI) for successful outcome after outpatient endoscopic decompression for lumbar foraminal and lateral recess stenosis. PATIENTS AND METHODS: A retrospective study of 1839 consecutive patients with an average mean follow-up of 33 months that underwent endoscopic transforaminal decompression at 2076 lumbar levels was conducted. The sensitivity, specificity, and positive predictive value of lidocaine containing diagnostic TESI at the intended surgical level were calculated based on the recorded frequency of >50% VAS score reduction, intraoperatively visualized stenosis, and clinical outcomes assessed by Macnab criteria and VAS reduction...
July 24, 2018: Clinical Neurology and Neurosurgery
Todd J Wannemuehler, Cyrus C Rabbani, Jack E Burgeson, Elisa A Illing, Evan S Walgama, Arthur W Wu, Jonathan Y Ting
Background: Endoscopic skull base surgery (ESBS) is a rapidly expanding field. Despite divergent reported preferences for reconstructive techniques and perioperative management, limited data exist regarding contemporary practice patterns among otolaryngologists performing ESBS. This study aims to elucidate current practice patterns, primarily the volumes of cases performed and secondarily a variety of other perioperative preferences. Methods: An anonymous 32-item electronic survey examining perioperative ESBS preferences was distributed to the American Rhinologic Society membership...
June 2018: Laryngoscope Investigative Otolaryngology
Gun Keorochana, Saran Pairuchvej, Kittipong Setrkraising, Alisara Arirachakaran, Jatupon Kongtharvonskul
No abstract text is available yet for this article.
July 27, 2018: World Neurosurgery
Chao Liu, Yue Zhou
OBJECTIVE: To compare the clinical outcomes of patients withlumbar disc herniation with bi-radicular symptomsundergoing percutaneous endoscopic lumbar discectomy and minimally invasive transforaminal lumbar interbody fusion at a single clinic. METHODS: From January 2008 to January 2016, 89consecutive patients with lumbar disc herniation with bi-radicular symptoms were treated with percutaneous endoscopic lumbar discectomy(PELD) or minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF)...
July 25, 2018: World Neurosurgery
Yu Wang, Qingyu Dou, Jin Yang, Lifeng Zhang, Yuqing Yan, Zhiyu Peng, Chuan Guo, Qingquan Kong
PURPOSE: The purpose of this study was to provide a new classification of the lateral region of the lumbar canal (LLSC) and evaluate the clinical outcome of surgical treatment of LLSC stenosis guided by the classification. METHODS: We developed a new functional classification of the LLSC by dividing the region into five zones. Thirty random lumbar imaging studies from single-level LLSC stenosis patients in our department from January 2015 to June 2015 were evaluated by 3 examiners to validate its reliability...
July 24, 2018: World Neurosurgery
Jonghyuk Baek, Seung Heon Yang, Chi Heon Kim, Chun Kee Chung, Yunhee Choi, Ji Han Heo, Sung Bae Park, Sung Hwan Hwang, Jong-Myung Jung, Kyoung-Tae Kim
BACKGROUND: Residual disc fragments are observed on immediate postoperative magnetic resonance imaging (MRI) in 2.8-15% of patients after percutaneous endoscopic lumbar discectomy (PELD). Considering the known postoperative longitudinal outcomes in patients with residual disc tissue, a 'watchful waiting' strategy may be preferable to immediate re-operation in patients with asymptomatic residual disc material. OBJECTIVES: The aim of the present study was to compare the longitudinal clinical outcomes between PELD patients in whom the complete removal of disc fragments was achieved (complete group) and those in whom residual disc fragments were observed on postoperative MRI (residual group)...
July 2018: Pain Physician
Hyeun Sung Kim, Byapak Paudel, Jee Soo Jang, Keun Lee, Seong Hoon Oh, Il Tae Jang
BACKGROUND: Lumbar disc herniation (LDH) is being treated with limited indication by percutaneous full endoscopic lumbar discectomy. However, microscopic lumbar discectomy (MLD) is still considered as a gold standard. OBJECTIVE: With the advances in spinal endoscopic instruments and surgical techniques, all LDHs have now become operable with percutaneous full endoscopic lumbar discectomy procedure. We report the results of percutaneous full endoscopic lumbar discectomy (PELD) for all patients diagnosed with LDH, including severely difficult and extremely difficult LDH cases who visited our clinic with leg pain and lower back pain...
July 2018: Pain Physician
Xin Huang, Bin Zhu, Xiaoguang Liu
BACKGROUND: Percutaneous endoscopic lumbar discectomy (PELD) has become an increasingly popular minimally invasive spinal surgery. Due to the technical evolution of PELD, the focus of decompression has shifted from the central nucleus to the subannular-protruded disc herniation, which allows direct neural decompression. Surgical entry into the spinal canal leads to the greater possibility of bony structure obstruction, thus the location and direction of the working channel are crucial...
July 2018: Pain Physician
Si Yin, Heng Du, Weizhou Yang, Chungguang Duan, Chaoshuai Feng, Huiren Tao
BACKGROUND: Percutaneous endoscopic lumbar discectomy (PELD) is a minimally invasive surgery for the treatment of lumbar disc herniation (LDH) with a smaller incision, decreased damage to soft tissues, faster recovery, and fewer postoperative complications. However, the exactly epidemiological prevalence of recurrent herniation after PELD remains unclear. OBJECTIVES: To investigate the epidemiological prevalence of recurrent herniation in patients following PELD and to analyze the potentially related risk factors...
July 2018: Pain Physician
Yuan Hong, Yuanjian Fang, Qun Wu, Jianmin Zhang, Yongjie Wang
INTRODUCTION: Ganglioglioma is a generally benign tumor, mostly occurring in patients <30 years old. Temporal lobe is most frequently involved. Up to now, only 3 cases were reported of ganglioglioma in the pituitary gland, all being confined to the neurohypophysis. Here, we are the first to report an adenohypophysis ganglioglioma. CASE PRESENTATION: A 43-year-old woman presented with chronic headache was referred to our hospital. Magnetic resonance imaging (MRI) indicated pituitary adenoma...
July 2018: Medicine (Baltimore)
X W Ye, S S Liu, B L Liu
Adolescent lumbar disc herniation(ALDH) is clinically rare. Factors such as dysplasia, genetic factors, trauma, spinal sagittal aligment have been suspected as the pathogenesis of ALDH. The clinical features of ALDH are different from adult lumbar disc herniation: typical physical signs with minor complaints, higher proportion of lumbar deformities. ALDH usually involves one segment, presenting central type, and the herniated disc is larger with bone structure.Conservative treatment is suggested for ALDH patients without severe nerve injury...
July 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Hsuan-Kan Chang, John Paul G Kolcun, Peng-Yuan Chang, Michael Y Wang
This video demonstrates the awake endoscopic minimally-invasive transforaminal lumbar interbody fusion (MIS-TLIF) used in our institution's developing Enhanced Recovery After Surgery program. This technique relies on 6 key components, including (1) conscious sedation, (2) endoscopic visualization, (3) long-acting local anesthesia, (4) an expandable interbody device, (5) osteobiologics, and (6) percutaneous instrumentation. In joining these technologies, this procedure embodies the principles of minimally invasive surgery while achieving excellent clinical outcomes...
July 19, 2018: Operative Neurosurgery (Hagerstown, Md.)
Michael Robert Gaab
No abstract text is available yet for this article.
July 19, 2018: World Neurosurgery
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