Endoscopic Spine Surgery, Challenges and Handicaps | ||
Iraqi Postgraduate Medical Journal | ||
Article 1, Volume 22, Issue 1, January 2023, Pages 1-2 PDF (135.12 K) | ||
DOI: 10.52573/ipmj.2023.178889 | ||
Abstract | ||
Full-endoscopic spine surgical techniques were developed to minimize the invasiveness of traditional spine surgeries. The beginnings of full-endoscopic spine surgery date back to the early 1970s, when transforaminal endoscopic spine surgery was developed as an evolution of needle-based percutaneous endoscopic discectomy, Full-endoscopic spine surgery is carried out via a working channel endoscope and requires generation of an artificial working space assisted by a tubular retractor. | ||
Full Text | ||
Full-endoscopic spine surgical techniques were developed to minimize the invasiveness of traditional spine surgeries. The beginnings of full-endoscopic spine surgery date back to the early 1970s, when transforaminal endoscopic spine surgery was developed as an evolution of needle-based percutaneous endoscopic discectomy, Full-endoscopic spine surgery is carried out via a working channel endoscope and requires generation of an artificial working space assisted by a tubular retractor. Progression of full-endoscopic spine surgery is facilitated by radiographic imaging, palpation, and visualization of anatomic target areas. Principal anatomic landmarks are described for all full- endoscopic procedures and allow for safe identification of neural structures. Both transforaminal and interlaminar approaches allow for access to the lumbar spinal column. Full-endoscopic spine surgery allows the surgeon to address common degenerative pathology. Traditional surgery should always be considered in cases of moderate to severe deformity or instability. Tubular retractor systems are a critical component of full- endoscopic spine surgery. The tubular retractor is necessary to generate an artificial working space, and the bevel is essential for dissection and retraction of neural structures. AOSpine Endoscopic Spine Surgery Nomenclature System Full-endoscopic surgical approaches typically progress in three stages
A- Full-Endoscopic Cervical Discectomy
B- Full-Endoscopic Thoracic Discectomy -Transforaminal endoscopic thoracic discectomy (TETD) C- Full-Endoscopic Lumbar Discectomy
D- Full-Endoscopic Foraminotomy
E- Full-Endoscopic Lumbar Lateral Recess Decompression
F- Full-Endoscopic Laminotomy For Bilateral Decompression
Endoscopic Surgical approaches:
Indications:
Relative contra-indications:
All these increase the risk for irritation or damage of the exiting nerve root
Pearls and Pitfalls of Interlaminar Approaches In patients with a congenitally narrow spinal canal or for the upper lumbar spinal segments Endoscopic spine surgery for soft disc herniation can be effective with benefits of minimal tissue trauma in properly selected cases Limitations of Endoscopic Surgery:
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References | ||
4. Andrew S Chung , Braden McKnight, Jeffrey C Wang , Scientific View on Endoscopic Spine Surgery: Can Spinal Endoscopy Become a Mainstream Surgical Tool?, Pages 708-711,World Neurosurgery Volume 145, January 2021 | ||
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