scholarly journals The modified transforaminal endoscopic technique in treating intracanalicular combining foraminal and/or extraforaminal lumbar disc herniations

2018 ◽  
Vol 8 (9) ◽  
pp. 936-945
Author(s):  
Yong Zhang ◽  
◽  
Zhimin Pan ◽  
Yanghong Yu ◽  
Daying Zhang ◽  
...  
Keyword(s):  
Lumbar Disc ◽  
Endoscopic Technique ◽  
Disc Herniations

scholarly journals The Current State of Endoscopic Disc Surgery: Review of Controlled Studies Comparing FullEndoscopic Procedures for Disc Herniations to Standard Procedures

2013 ◽  
Vol 4;16 (4;7) ◽  
pp. 335-344
Author(s):  
Christof Birkenmaier
Keyword(s):  
Neuropathic Pain ◽  
Lumbar Disc ◽  
Standard Procedure ◽  
Clinical Results ◽  
Endoscopic Technique ◽  
Complication Rates ◽  
Disc Surgery ◽  
Standard Procedures ◽  
Disc Herniations ◽  
Microsurgical Techniques

Background: Neuropathic pain originating from spinal disc herniations is a very common problem. The majority of disc surgeries are performed to alleviate this pain once conservative measures and targeted injections have failed. Endoscopic spinal surgery is increasingly popular because it minimizes access trauma and hastens recovery from the intervention. This clinically oriented review evaluates controlled studies that investigate the clinical results and the complications of full-endoscopic lumbar and cervical procedures for symptomatic disc herniations in comparison to a microsurgical standard procedure. This review focuses exclusively on modern, full-endoscopic disc surgery irrespective of the specific access technique (e.g., interlaminar vs. transforaminal) and irrespective of the spinal region. Study Design: Comprehensive review of the literature. Objective: To assess the clinical outcomes and complication rates of full-endoscopic disc surgery compared to the microsurgical standard procedures. Methods: A PubMed and Embase search was performed, considering entries up to January 2013. All 504 results were screened and categorized. Only 4 randomized controlled trials (RCTs) and one controlled studies (CS) could finally be considered for evaluation. All 5 manuscripts were meticulously analyzed with regards to randomization mode, inclusion/exclusion criteria, clinical results, and complication rates. Results: Overall, the endoscopic techniques had shorter operating times, less blood loss, less operative site pain, and faster postoperative rehabilitation/shorter hospital stay/faster return to work than the microsurgical techniques. There were no significant differences in the main clinical outcome criteria between the endoscopic and the microsurgical techniques in any of the trials. All 5 studies had fewer complications with the endoscopic technique and this was statistically significant in 2 of the studies. One study showed a lower rate of revision surgeries requiring arthrodesis with the endoscopic technique. Limitations: All 5 studies that could be considered originate from experienced investigators and all 4 RCTs came from one group. This limits the transferability of their results to surgeons less experienced in endoscopic disc surgery. Conclusions: The studies show that full-endoscopic disc surgery can achieve the same clinical results in symptomatic cervical and lumbar disc herniations as the microsurgical standard techniques. This does not appear to come at the price of higher complication rates. Key words: Neuropathic pain, disc herniation, cervical, lumbar, endoscopic, endoscopy, review

Long-term follow-up of standard microdiscectomy versus minimal access surgery for lumbar disc herniations

2013 ◽  
Vol 155 (12) ◽  
pp. 2333-2338 ◽  
Author(s):  
J. Gempt ◽  
M. Jonek ◽  
F. Ringel ◽  
A. Preuß ◽  
P. Wolf ◽  
...  
Keyword(s):  
Lumbar Disc ◽  
Minimal Access Surgery ◽  
Minimal Access ◽  
Long Term Follow Up ◽  
Disc Herniations ◽  
Access Surgery

Surgical treatment of intraforaminal/extraforaminal lumbar disc herniations: Many approaches for few surgical routes

2017 ◽  
Vol 159 (7) ◽  
pp. 1273-1281 ◽  
Author(s):  
Giorgio Lofrese ◽  
Lorenzo Mongardi ◽  
Francesco Cultrera ◽  
Giorgio Trapella ◽  
Pasquale De Bonis
Keyword(s):  
Surgical Treatment ◽  
Lumbar Disc ◽  
Disc Herniations

Extraforaminal microscopic assisted percutaneous nucleotomy for foraminal and extraforaminal lumbar disc herniations

2018 ◽  
Vol 18 (4) ◽  
pp. 620-625 ◽  
Author(s):  
Ahmed Shawky Abdelgawaad ◽  
Dusko Babic ◽  
Ahmed Ezzat Siam ◽  
Ali Ezzati
Keyword(s):  
Lumbar Disc ◽  
Disc Herniations

Diagnosis and microsurgical approach to far-lateral disc herniation in the lumbar spine

1990 ◽  
Vol 72 (3) ◽  
pp. 378-382 ◽  
Author(s):  
Joseph C. Maroon ◽  
Thomas A. Kopitnik ◽  
Larry A. Schulhof ◽  
Adnan Abla ◽  
James E. Wilberger
Keyword(s):  
Facet Joint ◽  
Lumbar Disc ◽  
Spinal Nerve ◽  
Magnetic Resonance Images ◽  
Content Type ◽  
Enhanced Ct ◽  
Disc Herniations ◽  
Microsurgical Approach ◽  
Far Lateral ◽  
Fine Print

✓ Lumbar-disc herniations that occur beneath or far lateral to the intervertebral facet joint are increasingly recognized as a cause of spinal nerve root compression syndromes at the upper lumbar levels. Failure to diagnose and precisely localize these herniations can lead to unsuccessful surgical exploration or exploration of the incorrect interspace. If these herniations are diagnosed, they often cannot be adequately exposed through the typical midline hemilaminectomy approach. Many authors have advocated a partial or complete unilateral facetectomy to expose these herniations, which can lead to vertebral instability or contribute to continued postoperative back pain. The authors present a series of 25 patients who were diagnosed as having far lateral lumbar disc herniations and underwent paramedian microsurgical lumbar-disc excision. Twelve of these were at the L4–5 level, six at the L5–S1 level, and seven at the L3–4 level. In these cases, myelography is uniformly normal and high-quality magnetic resonance images may not be helpful. High-resolution computerized tomography (CT) appears to be the best study, but even this may be negative unless enhanced by performing CT-discography. Discography with enhanced CT is ideally suited to precisely diagnose and localize these far-lateral herniations. The paramedian muscle splitting microsurgical approach was found to be the most direct and favorable anatomical route to herniations lateral to the neural foramen. With this approach, there is no facet destruction and postoperative pain is minimal. Patients were typically discharged on the 3rd or 4th postoperative day. The clinical and radiographic characteristics of far-lateral lumbar-disc herniations are reviewed and the paramedian microsurgical approach is discussed.

Access of Patients With Lumbar Disc Herniations to Spine Surgeons

Spine ◽  
2017 ◽  
Vol 42 (15) ◽  
pp. 1179-1183 ◽  
Author(s):  
Nidharshan S. Anandasivam ◽  
Daniel H. Wiznia ◽  
Chang-Yeon Kim ◽  
Ameya V. Save ◽  
Jonathan N. Grauer ◽  
...  
Keyword(s):  
Lumbar Disc ◽  
Disc Herniations

Microendoscopic Discectomy for Far Lateral Lumbar Disc Herniations

Neurosurgery ◽  
1998 ◽  
Vol 43 (3) ◽  
pp. 716-716
Author(s):  
Kevin T. Foley ◽  
Maurice M. Smith
Keyword(s):  
Lumbar Disc ◽  
Disc Herniations ◽  
Microendoscopic Discectomy ◽  
Far Lateral
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