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Minimally invasive lumbar disk

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...
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...
June 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
Jun Sato, Seiji Ohtori, Sumihisa Orita, Kazuyo Yamauchi, Yawara Eguchi, Nobuyasu Ochiai, Kazuki Kuniyoshi, Yasuchika Aoki, Junichi Nakamura, Masayuki Miyagi, Miyako Suzuki, Gou Kubota, Kazuhide Inage, Takeshi Sainoh, Kazuki Fujimoto, Yasuhiro Shiga, Koki Abe, Hiroto Kanamoto, Gen Inoue, Kazuhisa Takahashi
PURPOSE: Extreme lateral interbody fusion provides minimally invasive treatment of spinal deformity, but complications including nerve and psoas muscle injury have been noted. To avoid nerve injury, mini-open anterior retroperitoneal lumbar interbody fusion methods using an approach between the aorta and psoas, such as oblique lumbar interbody fusion (OLIF) have been applied. OLIF with percutaneous pedicle screws without posterior decompression can indirectly decompress the spinal canal in lumbar degenerated spondylolisthesis...
August 6, 2015: European Spine Journal
Yoshimi Endo, Theodore T Miller, Gregory R Saboeiro, Paul M Cooke
Discal cysts are extradural masses that communicate with the intervertebral disk and are a rare cause of lower back pain and lumbar radiculopathy. This case report describes a lumbar discal cyst, the diagnosis of which was confirmed on conventional discography, and which was treated with computed tomography-guided aspiration and steroid injection. Several reports have described this procedure, but only one in the radiology literature, and thus the purpose of this report is to remind the radiology community of the existence of this entity and propose a minimally invasive means of treatment...
December 2014: Journal of Radiology Case Reports
Daniele Vanni, Francesco S Sirabella, Matteo Guelfi, Andrea Pantalone, Renato Galzio, Vincenzo Salini, Vincenzo Magliani
Study Design Retrospective study. Objective The interlaminar approach represents the standard procedure for the surgical treatment of lumbar disk herniation (LDH). In the case of disk herniations in the "hidden zone," it could be necessary to perform laminotomies or laminectomies and partial or total facetectomies to remove the herniated fragment, thus leading to iatrogenic instability. The objective of the study is to evaluate the translaminar approach, in terms of the results, safety, and efficacy compared with the standard approach...
April 2015: Global Spine Journal
Paul Park
BACKGROUND: As with most minimally invasive spine procedures, lateral lumbar interbody fusion (LLIF) requires the use of biplanar fluoroscopy for localization and safe interbody cage placement. Computed tomography (CT)-based intraoperative spinal navigation has been shown to be more effective than fluoroscopic guidance for posterior-based approaches such as pedicle screw instrumentation. However, the use of spinal navigation in LLIF has not been well studied. OBJECTIVE: To present the technique for using an intraoperative cone-beam CT and image-guided navigation system in LLIF and to provide a preliminary analysis of outcomes...
June 2015: Neurosurgery
Masoud Hashemi, Majid Poorfarokh, Seyed Amir Mohajerani, Parviz Jalili, Vahid Akhyani, Ameneh Barikani, Farshad Farivar
BACKGROUND: Disk herniation (DH) is one of the most common disk lesions, inducing low back pain (LBP). Various therapeutic options have been proposed for treatment of disk herniation (DH). Intradiscal injection of ozone has been suggested for treatment of DH. OBJECTIVES: To determine the effect of intradiscal ozone injection on pain score and disability in patients with LBP from disk prolapsed. PATIENTS AND METHODS: Patients with LBP diagnosed with DH were enrolled in this clinical trial study...
December 2014: Anesthesiology and Pain Medicine
Xue-Song Wang, Rui-Fu Sun, Qiang Ji, Bing Zhao, Xuan-Min Niu, Rong Wang, Lei Peng, Xiao-Dong Tian
A meta-analysis was conducted to evaluate the evidence that compared the safety and efficacy of interlaminar minimally invasive discectomy (ILMI) and conventional microdiscectomy (MD) for treating lumbar disk herniation (LDH) patients and to develop GRADE based recommendations for using the procedures to treat LDH. Eleven studies, encompassing 1012 patients, met the inclusion criteria. Overall, the results of the meta-analysis indicated that there were significant differences between the two groups in blood loss (SMD=-0...
December 2014: Clinical Neurology and Neurosurgery
M Bellini, D G Romano, S Leonini, I Grazzini, C Tabano, M Ferrara, P Piu, L Monti, A Cerase
BACKGROUND AND PURPOSE: Chemonucleolysis represents a minimally invasive percutaneous technique characterized by an intradiskal injection of materials under fluoroscopic or CT guidance. Recently, a substance based on radiopaque gelified ethanol has been introduced. The purpose of this study was to describe the indications, procedure, safety, and efficacy of radiopaque gelified ethanol in the percutaneous treatment of cervical and lumbar disk herniations. MATERIALS AND METHODS: Between September 2010 and August 2013, 80 patients (32 women and 48 men; age range, 18-75 years) were treated for 107 lumbar disk herniations (L2-L3, n = 1; L3-L4, n = 15; L4-L5, n = 53; and L5-S1, n = 38) and 9 cervical disk herniations (C4-C5, n = 2; C5-C6, n = 2; C6-C7, n = 3; and C7-D1, n = 2) by percutaneous intradiskal injection of radiopaque gelified ethanol under fluoroscopic guidance...
March 2015: AJNR. American Journal of Neuroradiology
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