[Development of percutaneous endoscopic approach for lumbar disc herniations].

Related Articles
[Development of percutaneous endoscopic approach for lumbar disc herniations].
Nihon Rinsho. 2010 Jul;68(7):1383-90
Authors: Dezawa A
Abstract
“Primum nil nocere” (minimally invasive procedure…

read more

High-definition imaging in spinal neuroendoscopy.

Related Articles
High-definition imaging in spinal neuroendoscopy.
Minim Invasive Neurosurg. 2010 Jun;53(3):142-6
Authors: Philipps M, Oertel J
Abstract
BACKGROUND: Spinal endoscopy is still under controversi…

read more

Percutaneous endoscopic lumbar herniectomy for high-grade down-migrated L4-L5 disc through an L5-S1 interlaminar approach: a technical note.

Related Articles
Percutaneous endoscopic lumbar herniectomy for high-grade down-migrated L4-L5 disc through an L5-S1 interlaminar approach: a technical note.
Minim Invasive Neurosurg. 2010 Jun;53(3):147-52
Authors: Choi G, P…

read more

Percutaneous endoscopic laser annuloplasty for discogenic low back pain.

Related Articles
Percutaneous endoscopic laser annuloplasty for discogenic low back pain.
World Neurosurg. 2010 Mar;73(3):198-206; discussion e33
Authors: Lee SH, Kang HS
Abstract
BACKGROUND: Laser-assisted s…

read more

Endoscopic anterior cervical discectomy under epidurogram guidance.

Related Articles
Endoscopic anterior cervical discectomy under epidurogram guidance.
Surg Technol Int. 2010 Oct;20:373-8
Authors: Liu KX, Massoud B
Abstract
Cervical discectomy is commonly required for spinal …

read more

Operative management of lumbar disc herniation : the evolution of knowledge and surgical techniques in the last century.

Related Articles
Operative management of lumbar disc herniation : the evolution of knowledge and surgical techniques in the last century.
Acta Neurochir Suppl. 2011;108:17-21
Authors: Postacchini F, Postacchini R
Abst…

read more

Percutaneous endoscopic lumbar discectomy and interbody fusion with B-Twin expandable spinal spacer.

Related Articles

Percutaneous endoscopic lumbar discectomy and interbody fusion with B-Twin expandable spinal spacer.

Arch Orthop Trauma Surg. 2011 Jun;131(6):791-6

Authors: Yao N, Wang W, Liu Y

Abstract
BACKGROUND: Posterior lumbar interbody fusion (PLIF) is biomechanically sound as it ablates the degenerated disc, restores the intervertebral height, relieves foraminal stenosis, and positions the bone graft along the weight-bearing axis. But this conventional procedure also results in significant traction on the dural sac and the cauda equina and is thereby a potential source of neurologic damage. Therefore, we performed a minimally invasive technique: percutaneous endoscopic discectomy and interbody fusion (PEDIF) with B-Twin expandable spinal spacer (B-twin ESS) to treat symptomatic lumbar degenerative disc disease and explored the clinical outcome.
METHODS: From June 2004 to December 2006, 43 consecutive patients with symptomatic lumbar degenerative disc disease were included in this study. There were 28 males and 15 females, with average age of 47 years (range 26-63). Following a routine micro-endoscopic discectomy or percutaneous nucleotomy, endplate curettage was meticulously carried out. The intervertebral space was packed with autograft cancellous bone cut from lumbar delivered through a 5-mm diameter funnel. The B-twin ESS was introduced into the intervertebral space and then expanded. Both stages were monitored by C-arm fluoroscopy.
RESULTS: The mean operative time was 110 ± 36 min (80-150). The mean blood loss was 350 ± 68 ml (210-700). The mean length of hospitalization was 6.6 ± 2.9 days (3-10). All patients were evaluated in follow-up of 12-30 months (mean 18). According to radiological evidence of fusion on dynamic X-ray plain film, 31 cases (72.1%) achieved bone graft fusion after 6 months postoperatively; at the final follow-up, union of the bone graft has been established in all but one patient (97.7%). The subsidence degree of the B-twin ESS was 20-30% in 2 cases and in rest of the cases less than 10%. According to the modified criteria of Chinese Orthopaedic Association, excellent in 31 cases, good in 8 cases, fair in 3 cases, poor in 1 case, and the rate of excellent and good cases was 91%.
CONCLUSION: The PEDIF technique provided an option for percutaneous interbody fusion similar to that in open surgery while minimizing destruction to adjacent tissues. This technique was safe and exhibited a trend toward decreased intraoperative blood loss, length of stay and the risk of neurological complications.

PMID: 21161663 [PubMed – indexed for MEDLINE]

read more

The economics of minimally invasive spine surgery: the value perspective.

Related Articles
The economics of minimally invasive spine surgery: the value perspective.
Spine (Phila Pa 1976). 2010 Dec 15;35(26 Suppl):S375-82
Authors: Allen RT, Garfin SR
Abstract
STUDY DESIGN: Review of…

read more

Foraminoplastic ventral epidural approach for removal of extruded herniated fragment at the L5-S1 level.

Related Articles
Foraminoplastic ventral epidural approach for removal of extruded herniated fragment at the L5-S1 level.
Neurol Med Chir (Tokyo). 2010;50(12):1074-8
Authors: Lee SH, Kang HS, Choi G, Kong BJ, Ahn Y, Kim JS, …

read more

[Comparison of treatment with micro endoscopic discectomy and posterior lumbar interbody fusion using single and double B-Twin expandable spinal spacer].

Related Articles

[Comparison of treatment with micro endoscopic discectomy and posterior lumbar interbody fusion using single and double B-Twin expandable spinal spacer].

Zhonghua Wai Ke Za Zhi. 2010 Nov 1;48(21):1637-41

Authors: Zhang DQ, Yang Q, Jiang CM, Wu CM, Ma K, Tang K, Liu Y, Wang B

Abstract
OBJECTIVE: To compare the therapeutic effect of posterior lumbar interbody fusion by single and double B-Twin expandable spinal spacer with micro endoscopic discectomy (MED) for lumbar intervertebral disc protrusion accompanying degenerative instability.
METHODS: From March 2006 to May 2008, 45 patients with lumbar intervertebral disc protrusion accompanying degenerative instability were admitted and managed with posterior lumbar interbody fusion by B-Twin expandable spinal spacer with MED. The patients were randomly assigned to treatment with single B-Twin (Single group, n = 24) or double B-Twin (Double group, n = 21). There were 16 males and 8 females, with an average age of 45.5 years (43 – 60 years) in Single group; 13 males and 8 females, with an average age of 43.7 years (44-61 years) in Double group. All the cases suffered from only one level disc protrusion, L(3-4) 2 cases, L(4-5) 29 cases and L₅-S₁ 14 cases. Clinical outcomes were evaluated with surgical time, blood loss, visual analogue scale (VAS) scores preoperatively, 1, 3, 6 month postoperatively. Oswestry disability questionnaire (ODI) of the preoperative, 1 month postoperative, and latest follow-up and the disk space heights.
RESULTS: Forty three patients were followed-up for 1 to 3 years after surgery. The mean surgical time of Double group was longer than Single group [(152 ± 32) min vs. (91 ± 15) min, P < 0.01]. The average blood loss in Double group was more than that in Single group [(146 ± 73) ml vs. (95 ± 58) ml, P < 0.01]. The mean time of hospital stay in Single group was similar to that in Double group [(11.0 ± 3.2) d vs. (10.9 ± 3.3) d, P > 0.05]. Both groups could keep the disk space heights till the last follow-up [(7.7 ± 1.8) mm vs. (8.5 ± 1.7) mm]. In the 6 months follow-up post operation, the VAS score decreased from (8.1 ± 1.8) to (2.0 ± 1.0) in Single group, and (8.1 ± 1.9) to (2.1 ± 1.0) in Double group. At the last follow-up, the ODI decreased from (36 ± 7)% to (10 ± 4)% in Single group and (37 ± 6)% to (9 ± 4)% in Double group, but there was no significant difference between the two groups (P > 0.05). All the cases achieved fusion at the last follow-up, 3 patients in Single group and 2 patients in Double group suffered from intractable low back pain. One of the fins broke in one patient without any uncomfortable feeling.
CONCLUSIONS: Compared with the management of lumbar intervertebral disc protrusion accompanying degenerative instability by double B-Twin expandable spinal spacer with micro endoscopic discectomy, the single B-twin can get similar clinical outcomes, but shorter surgical time, less blood loss and less medical costs.

PMID: 21211259 [PubMed – indexed for MEDLINE]

read more