scholarly journals State of the Art: Transforaminal Approach for Percutaneous Endoscopic Lumbar Discectomy under Local Anesthesia

2014 ◽  
Vol 61 (3.4) ◽  
pp. 217-225 ◽  
Author(s):  
Koichi Sairyo ◽  
Hiroshi Egawa ◽  
Tetsuya Matsuura ◽  
Mitsuhiko Takahashi ◽  
Kosaku Higashino ◽  
...  
Keyword(s):  
Local Anesthesia ◽  
State Of The Art ◽  
Lumbar Discectomy ◽  
Percutaneous Endoscopic Lumbar Discectomy ◽  
Transforaminal Approach ◽  
Endoscopic Lumbar Discectomy

scholarly journals Robot Assisted Transforaminal Percutaneous Endoscopic Lumbar Discectomy

10.29007/34nd ◽  
2018 ◽  
Author(s):  
Han Wang ◽  
Yajun Liu ◽  
Mingxing Fan ◽  
Jile Jiang ◽  
Wei Tian
Keyword(s):  
Clinical Results ◽  
Needle Insertion ◽  
Lumbar Discectomy ◽  
Learning Curves ◽  
Computer Assisted ◽  
Percutaneous Endoscopic Lumbar Discectomy ◽  
Assisted Navigation ◽  
Endoscopic Spine Surgery ◽  
Transforaminal Approach ◽  
Endoscopic Lumbar Discectomy

Percutaneous endoscopic spine surgery is popular in recent years because of its minimally invasive manner. After transforaminal approach presented by Kambin in the late 1980s, many specific methods were described to establish an accurate and feasible approach to the target disc. Among them, the techniques of Yeung[1], Hoogland[2] and Ruetten[3] are the most famous ones and each has different design and indications. However, no consensus have been made because of the debated clinical results, steep learning curves, and pitfalls that exist in each approach. Guide needle insertion and subsequent working channel building remain a challenging procedure. Poor accuracy may lead to poor safety as the nerve root and dura are at risk. Many surgeons attempted to optimize the procedure, but few researches have integrated computer-assisted navigation with tPELD (transforaminal percutaneous endoscopic lumbar discectomy). It is time to bring our surgical robot into the field.

scholarly journals A Retrospective Comparative Study of Local Anesthesia Only and Local Anesthesia with Sedation for Percutaneous Endoscopic Lumbar Discectomy

2021 ◽  
Author(s):  
Liu Yang ◽  
Yu-Lin Pan ◽  
Chun-Zhi Liu ◽  
De-Xin Guo ◽  
Xin Zhao
Keyword(s):  
Clinical Outcomes ◽  
Local Anesthesia ◽  
Lumbar Discectomy ◽  
Control Group ◽  
Surgical Experience ◽  
Lumbar Disk Herniation ◽  
Percutaneous Endoscopic Lumbar Discectomy ◽  
Retrospective Comparative Study ◽  
Endoscopic Lumbar Discectomy ◽  
Surgical Duration

Abstract The purpose of this study was to compare surgical experience and clinical outcomes of lumbar disk herniation (LDH) patients treated with percutaneous endoscopic lumbar discectomy (PELD) using local anesthesia only and local anesthesia with sedation. Ninety-two consecutive LDH patients were divided into four groups: control group (Con Group), dexmedetomidine group (Dex Group), oxycodone group (Oxy Group), and dexmedetomidine + oxycodone group (Dex + Oxy Group). Mean arterial pressure (MAP), heart rate (HR), Ramsay score and VAS score were compared before anesthesia (T1), working cannula establishment (T2), nucleus pulposus removal (T3), and immediately postoperative (T4). Surgical duration, hospitalization and MacNab criteria were evaluated. In control group, MAP and HR at T2 and T3 were higher than T1 (P < 0.05). In Dex, Oxy, and Dex + Oxy groups, MAP and HR at T2, T3, T4 were lower than T1, but Ramsay scores at T2, T3, T4 were higher than T1 (P < 0.05). VAS scores in all groups were improved postoperative (p>0.05). The clinical outcomes have no significant differences among the four groups (P > 0.05). We concluded that the combination of dexmedetomidine and oxycodone under local anesthesia is an effective method to improve surgical experience and reduce anxiety in suitable LDH patients.

scholarly journals Percutaneous Endoscopic Lumbar Discectomy for Highly Migrated Lumbar Disc Herniation

2017 ◽  
Vol 1 (21;1) ◽  
pp. E75-E84 ◽  
Author(s):  
Zhong-Liang Deng
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Lumbar Discectomy ◽  
Percutaneous Endoscopic Lumbar Discectomy ◽  
Transforaminal Approach ◽  
Interlaminar Approach ◽  
Operation Duration ◽  
The Mean ◽  
Endoscopic Lumbar Discectomy

Background: Percutaneous endoscopic lumbar discectomy (PELD) has been growing in popularity for the treatment of lumbar disc herniation (LDH) due to its irreplaceable advantages over conventional open surgery. Compared with common lumbar disc herniations, discectomy of highly migrated LDH by PELD is known to be very difficult. Highly migrated lumbar disc herniation has long been a challenge for its specific characteristics. Three approaches for PELD have been applied to access a highly migrated LDH, including an interlaminar approach (IL), transforaminal approach (TF), and contralateral transforaminal approach (CTF). However, none of the existing research has systematically described the selection of the most appropriate procedure from the 3 approaches or the individualization of an operative procedure in different cases. Objectives: The purpose of this study was to present a detailed surgical approach selection and individualization of procedure in the treatment of highly migrated LDH with PELD. We also mean to compare the outcomes of patients with highly migrated LDH treated with PELD by the 3 approaches. Study Design: Single-center retrospective observational study. Setting: An interventional pain management practice, a medical center, major metropolitan city, China. Methods: In our retrospective analysis between March 2011 and March 2013, 73 patients with single level highly migrated LDH received PELD. Clinical outcomes were assessed with the visual analogue scale (VAS) score, the modified MacNab criteria, and the Oswestry disability index (ODI). Relevant data such as operation duration and fluoroscopy frequency of the 3 operative approaches were recorded. Results: The mean operating time of IL was 56 minutes, compared with 64 minutes for TF and 112 minutes for CTF. The mean intraoperative fluoroscopy times were 5.5 for IL, 9.7 for TF, and 14.6 for CTF. In each group, the mean VAS and ODI after surgery and 3 months after surgery improved dramatically compared with preoperative counterparts. However, the difference between postoperative results and the results 3 months after surgery was not significant (P > 0.05). The overall excellent rate was 90.4% according to the modified MacNab criteria; there was no significant statistical difference between the 3 operative routes. Operative complications occurred in 3 patients (2 after IL and one after CTF, 3 of 73, 4.1%). Limitations: This study is limited by its sample size. Conclusion: In our research, PELD with all 3 approaches was similarly effective to highly migrated disc herniation. The CTF approach required the longest operation duration and the most intraoperative times. On the contrary, the least operation time and radiographfrequency was required with the IL approach. In addition, we came to a conclusion of surgery approach selection when it comes to varied HM-LDH. Key words: Highly migrated, lumbar disc herniation, percutaneous endoscopic lumbar discectomy, minimally invasive treatment Pain Physician 2017;

scholarly journals Surgical Outcome of Two-Level Transforaminal Percutaneous Endoscopic Lumbar Discectomy for Far-Migrated Disc Herniation

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Xinbo Wu ◽  
Guoxin Fan ◽  
Xin Gu ◽  
Xiaofei Guan ◽  
Shisheng He
Keyword(s):  
Conservative Treatment ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Lumbar Discectomy ◽  
Percutaneous Endoscopic Lumbar Discectomy ◽  
Transforaminal Approach ◽  
Recurrent Herniation ◽  
The Mean ◽  
Endoscopic Lumbar Discectomy

Objective.To describe the two-level percutaneous endoscopic lumbar discectomy (PELD) technique in transforaminal approach for highly migrated disc herniation and investigate its clinical outcomes.Methods.A total of 22 consecutive patients with highly migrated lumbar disc herniation were enrolled for the study from June 2012 to February 2014.Results.There were 12 males and 10 females, with a mean age of 41.1 (range 23–67) years. The mean follow-up period was 18.05 (range 14–33) months. According to the modified MacNab criteria, the clinical outcome at the final follow-up was excellent in 14, good in 6, and fair in 2 patients and the satisfactory rate (excellent and good) was 90.9%. The improvements in VAS and ODI were statistically significant. One patient had recurrent herniation in 18 months after the first surgery and underwent open discectomy. One patient showed symptoms of postoperative dysesthesia (POD), but the POD symptom was transient and partial remission was achieved in two months after conservative treatment.Conclusion.Two-level PELD in transforaminal approach can be a safe and effective procedure for highly migrated disc herniation.

Sign in / Sign up

Export Citation Format

Share Document