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Minimally invasive lumbar disk

Heeren S Makanji, Hai Le, Kirkham B Wood, Louis G Jenis, Thomas D Cha
STUDY DESIGN: Cross-sectional study reviewing 62 magnetic resonance imaging or computed tomography scans from consecutive adult patients with scoliotic spinal deformity in the thoracolumbar spine. OBJECTIVE: To investigate the variation in anatomic position of retroperitoneal vessels in relationship to curve direction, location, magnitude, and axial rotation of curves in adult scoliosis. SUMMARY OF BACKGROUND DATA: The minimally invasive lateral approach to the thoracolumbar spine avoids manipulation of abdominal and retroperitoneal structures and decreases risk of injury to paraspinal musculature...
March 6, 2017: Clinical Spine Surgery
Daniel R Felbaum, Jeffrey J Stewart, Casey Distaso, Faheem A Sandhu
Revision lumbar discectomy, given the disruption of anatomic planes, can be a more technically complicated operation. Historically, it may have higher complication rates than first-time microdiscectomy. Recently, minimally invasive tubular discectomy (MITD) has been reported as an equivalent treatment to traditional approaches and may have better utility for revision surgery. A retrospective review of MITDs performed by the senior surgeon (F.A.S.) on 42 patients with single-level, recurrent disk herniation was analyzed...
March 6, 2017: Clinical Spine Surgery
Hamid Abbasi, Ali Abbasi
BACKGROUND: Minimally invasive direct lateral interbody fusion (MIS-DLIF) is a novel approach for fusions of the lumbar spine. In this proof of concept study, we describe the surgical technique and report our experience and the perioperative outcomes of the first nine patients who underwent this procedure. STUDY DESIGN/SETTING: In this study we establish the safety and efficacy of this approach. MIS-DLIF was performed on 15 spinal levels in nine patients who failed to respond to conservative therapy for the treatment of a re-herniated disk, spondylolisthesis, or other severe disk disease of the lumbar spine...
January 14, 2017: Curēus
Ya-Peng Wang, Ji-Long An, Ya-Peng Sun, Wen-Yuan Ding, Yong Shen, Wei Zhang
OBJECTIVE: The aim of this study was to compare the curative effect between minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and the posterior lumbar interbody fusion (PLIF) in obese patients with lumbar disk prolapse. PATIENTS AND METHODS: In this study, 72 patients who underwent lumbar disk prolapse therapy in the Third Hospital of Hebei Medical University between March 2011 and 2015 were retrospectively analyzed and were divided into two groups, MIS-TLIF group (n=35) and PLIF group (n=37), according to different surgical procedures...
2017: Therapeutics and Clinical Risk Management
Jie Jin, Kyeong-Sik Ryu, Jung-Woo Hur, Ji-Hoon Seong, Jin-Sung Kim, Hyun-Jin Cho
STUDY DESIGN: Retrospective observatory analysis. OBJECTIVE: The purpose of this study was to compare the incidence of perioperative complication, difference of cage location, and sagittal alignment between minimally invasive oblique lateral lumbar interbody fusion (MIS-OLIF) and MIS-direct lateral lumbar interbody fusion (DLIF) in the cases of single-level surgery at L4-L5. SUMMARY OF BACKGROUND DATA: MIS-DLIF using tubular retractor has been used for the treatment of lumbar degenerative diseases; however, blunt transpsoas dissection poses a risk of injury to the lumbar plexus...
January 4, 2017: Clinical Spine Surgery
Alexander Spiessberger, Fabian Baumann, Martin Häusler, Frank Rühli, Javier Fandino, Carl Muroi
STUDY DESIGN: A laboratory cadaveric study. OBJECTIVE: We aimed to demonstrate the feasibility of a posterior oblique approach, sharing the same advantages as the transpsoas technique while minimizing the risk of lumbar plexus or psoas muscle injuries. SUMMARY OF BACKGROUND DATA: The transpsoas approach for interbody fusion and corpectomy offers advantages over posterior and anterior approaches. However, possible risks include traumatization of the psoas muscle or lumbar plexus...
November 21, 2016: Clinical Spine Surgery
Po-Chou Liliang, Kang Lu, Cheng-Loong Liang, Ya-Wen Chen, Yu-Duan Tsai, Yuan-Kun Tu
PURPOSE: Nucleoplasty is a minimally invasive technique that is considered efficacious in alleviating lumbar disk degenerative low back pain (LBP). The efficacy of nucleoplasty and identified variables that can predict pain relief for nucleoplasty was reported. PATIENTS AND METHODS: Between December 2013 and November 2015, 47 nucleoplasty procedures on 47 lumbar disks in 31 consecutive patients were performed. The outcome was evaluated using a visual analog scale (VAS) score...
2016: Journal of Pain Research
Reid Hoshide, Erica Feldman, Anisha Narayan, William Taylor
BACKGROUND: The natural, inflammatory repair processes of an injured intervertebral degenerative disc can propagate further injury and destruction. While there are many different treatment modalities of the pain related to degenerative disc disease, none are actually reparative in nature. Treatment strategies to repair a degenerative disc without inducing a destructive inflammatory milieu have been elusive.  PURPOSE: The purpose of this experiment is to discover the feasibility of reconstructing an injured intervertebral disc using an injected, inert polymer as the foundation for endogenous collagen growth...
August 8, 2016: Curēus
Agnieszka Saracen, Zbigniew Kotwica
Percutaneous vertebroplasty (PVP) is a minimally invasive procedure widely used for the treatment of pain due to vertebral fractures of different origins-osteoporotic, traumatic, or neoplastic. PVP is minimally invasive, but the complications are not rare; however, they are in most cases not significant clinically. The most frequent is cement leakage, which can occur onto veins, paravertebral soft tissue, into the intervertebral disk, or to the spinal canal, affecting foraminal area or epidural space. We analyzed results of treatment and complications of vertebroplasty performed with the use of polimethylomethylacrylate cement (PMMA) on 1100 vertebrae, with a special regard to the severity of complication and eventual clinical manifestation...
June 2016: Medicine (Baltimore)
Jeffrey B Kleiner, Hannah M Kleiner, E John Grimberg, Stefanie J Throlson
STUDY DESIGN: Disk material removed (DMR) during L4-5 and L5-S1 transforaminal lumbar interbody fusion (T-LIF) surgery was compared to the corresponding bone graft (BG) volumes inserted at the time of fusion. A novel BG delivery tool (BGDT) was used to apply the BG. In order to establish the percentage of DMR during T-LIF, it was compared to DMR during anterior diskectomy (AD). This study was performed prospectively. SUMMARY OF BACKGROUND DATA: Minimal information is available as to the volume of DMR during a T-LIF procedure, and the relationship between DMR and BG delivered is unknown...
2016: Medical Devices: Evidence and Research
Timur M Urakov, Amanda M Casabella, Howard B Levene
BACKGROUND: Pyogenic spondylodiskitis is an infection of intervertebral disks and spinal vertebral bodies. Various minimally invasive approaches to the infected disk spaces/abscesses have been described for management of early stages of the infection. Patients with chronic occurrence present with extensive infection, neurologic deficits, and bone destruction. Such patients commonly have substantial medical comorbidities. Despite the increased risks of complications, they often are treated with open surgical approaches without minimally invasive options...
August 2016: World Neurosurgery
Holger Joswig, Heiko Richter, Sarah Roberta Haile, Gerhard Hildebrandt, Jean-Yves Fournier
Background and Study Objective Interlaminar full-endoscopic diskectomy is a minimally invasive surgical alternative to microdiskectomy for the treatment of lumbar disk herniation. The authors analyze their surgical results and learning curves during and after the introductory phase of this surgical technique. Patients and Methods We present a case review of 76 patients operated on using interlaminar full-endoscopic diskectomy. We retrospectively analyzed two spinal surgeons' learning curves in terms of operation time with respect to intraoperative blood loss, conversion rates, complications, infections, length of hospitalization, need for rehabilitation, recurrence rates, pain intensity, and opioid use...
September 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Tom R Jansen, Rahel Bornemann, Philip P Roessler, Yorck Rommelspacher, Andreas C Strauss, Sönke P Frey, Kirsten Sander, Dieter C Wirtz, Robert Pflugmacher
BACKGROUND: Patients with lumbar degenerative disk disease (DDD) often require an interbody fusion. Several spacer systems have been developed to achieve an adequate fusion. The newly developed flexible interbody spacer system (Luna®, Benvenue Medical Inc.) expands to the disk space and is adjustable to the patient's anatomy. OBJECTIVE: Prospective monocentric evaluation of interbody fusions performed with the new system in patients with DDD to assess the device's efficacy and safety...
September 14, 2016: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
Didier Recoules-Arche, Claudia Druschel, Paul Fayada, Laurent Vinikoff, Alexander C Disch
STUDY DESIGN: Description of the technique and retrospective study of patients treated with unilateral extraforaminal lumbar interbody fusion (ELIF) for degenerative lumbar spinal disorders. OBJECTIVE: To investigate clinical and radiologic outcome of patients treated with unilateral ELIF. SUMMARY OF BACKGROUND DATA: Lumbar interbody fusion is the classic treatment for higher grades of degenerative disk disease or lumbar segment instability and is performed by posterior (PLIF), posterolateral, or anterior (ALIF) approaches...
April 2016: Clinical Spine Surgery
Serbülent Gökhan Beyaz, Mustafa Erkan İnanmaz, Ezgi Şen Zengin, Ali Metin Ülgen
UNLABELLED: Different minimally invasive procedures are used to treat lumbar disk herniation. It is important to differentiate these techniques due to their specific effects and the disparate technical issues associated with each. This report describes a successful case involving the use of mechanical decompression in conjunction with radiofrequency ablation to treat a patient with pain and neurological deficits due to an extruded disk hernia. CASE REPORT: A 43-year-old male had magnetic resonance imaging (MRI) demonstrating an extruded disk herniation in the left foraminal region, compression at the left spinal nerve root, and obliteration of the left foraminal entrance of the L5-S1 distribution...
2016: Pain Practice: the Official Journal of World Institute of Pain
Neil Badlani, Elizabeth Yu, Junyoung Ahn, Mark F Kurd, Safdar N Khan
Herniated disks in the lumbar spine typically present with the sudden onset of back and leg pain in a myodermatomal distribution. Symptoms may include radicular pain, paresthesias, and in extreme cases weakness or foot drop. Typically patients are treated conservatively for 6-8 weeks with a combination of steroids, nonsteroidal anti-inflammatory drugs, physical therapy, epidural steroid injections, and rest. In the absence of symptom improvement, surgical intervention typically with a microdisectomy is recommended to patients who are refractory to at least 6 weeks of nonoperative treatment...
April 2016: Clinical Spine Surgery
Pravesh S Gadjradj, Biswadjiet S Harhangi
Percutaneous transforaminal endoscopic discectomy (PTED) is a minimally invasive technique to treat lumbar disk herniation from a lateral approach. Performed under local anesthesia, the incision size for PTED is around 8 mm with no paraspinal muscle cutting or detachment from their insertion. PTED has been associated with less blood loss, faster rehabilitation, and less scarring of tissue than conventional open microdiscectomy. High-quality randomized controlled trials comparing PTED with open microdiscectomy have not been conducted yet...
March 3, 2016: Clinical Spine Surgery
Brian Kwon, David Hanwuk Kim
Lateral lumbar interbody fusion is a minimally invasive spinal fusion technique that uses the retroperitoneal approach to the anterior spinal column. Mechanical and technical results of the technique compare favorably with those of anterior lumbar interbody fusion in regard to large graft placement, graft volumes, and early initial stability. Lateral lumbar interbody fusion uses the transpsoas approach and traverses near the lumbar plexus. It is not, however, without its unique complications. Groin pain or numbness is well tolerated and often temporary; however, quadriceps palsy can be long-lasting and debilitating...
February 2016: Journal of the American Academy of Orthopaedic Surgeons
T Sanusi, J Davis, N Nicassio, I Malik
OBJECTIVES: Since the turn of the century, minimally invasive surgery has become increasingly widespread. Discectomy surgery has evolved from wide open to microscopic and now endoscopic. This study aims to demonstrate that transforaminal endoscopic discectomy is an alternative and safe approach for degenerative disk surgery. PATIENTS AND METHODS: Two year retrospective assessments of patients who underwent transforaminal endoscopic discectomy at a tertiary neurosurgical center in the United Kingdom by a single surgeon...
December 2015: Clinical Neurology and Neurosurgery
Hasan Syed, Jean-Marc Voyadzis
Objective The last decade has seen significant advances in minimally invasive techniques for lumbar interbody fusion that have reduced approach-related morbidity. Percutaneous lumbar interbody fusion involves a posterior transforaminal approach to the disk space with a minimal access port through the Kambin triangle. This technique obviates the need for the facetectomy or laminectomy required in a traditional transforaminal approach. This article describes the surgical technique, potential advantages and limitations, and representative case illustrations...
July 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
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