1
|
Feng L, Li W, Lai J, Yang W, Wu S, Liu J, Ma R, Lee S, Tian J. Validity of A Novel Simulator for Percutaneous Transforaminal Endoscopic Discectomy. World Neurosurg 2024:S1878-8750(24)00633-8. [PMID: 38641247 DOI: 10.1016/j.wneu.2024.04.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 04/11/2024] [Accepted: 04/12/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND Percutaneous transforaminal endoscopic discectomy (PTED) has steep learning curves and a high incidence of complications, but currently, efficient and economical training methods are lacking. This study aimed to validate a novel simulator for PTED. METHODS The simulated PTED included puncturing and establishing the working channel (PEWC) and endoscopic discectomy, with the PEWC being the tested module. Eleven experts and 21 novices were included and introduced to the simulator and tasks; all participants completed the PEWC. Outcomes included: total operation time, number of fluoroscopy for positioning the working sheath, number of spinal risk region invasion, Global Rating Scale (GRS) and a modified GRS, etc. The Mann-Whitney U test was used to compare 2 groups. Spearman's correlation coefficient analyzed continuous variables. RESULTS Experts outperformed novices in total operation time (P = 0.001), requiring fewer number of fluoroscopies for positioning the working sheath (P = 0.003). Additionally, experts had a lower number of spinal risk region invasions (P = 0.016) and higher scores on both the GRS (P < 0.001) and modified GRS (P < 0.001). PTED experience correlated with GRS scores (P = 0.001) and modified GRS (P < 0.001). The overall realism scored a median of 4 (3.75-5), and educational value had a median of 4 (range 3-5). CONCLUSIONS This study demonstrates the validity of the novel simulator, revealing significant associations between PTED experience and performance metrics in a simulated PEWC setting. Furthermore, the PEWC module also offers a good realistic design and high education value according to experts.
Collapse
Affiliation(s)
- Lei Feng
- Department of Orthopedics, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Wei Li
- Department of Orthopedics, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jianming Lai
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Weihao Yang
- Department of Orthopedics, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Shangxing Wu
- Department of Orthopedics, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jiajia Liu
- Department of Orthopedics, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Ruixin Ma
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Soomin Lee
- Clinical Skills Training Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jing Tian
- Clinical Skills Training Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
| |
Collapse
|
2
|
Xu D, Shu W, Lian L, Jiang W, Hu X, Gan K, Ma W. The clinical effect of unilateral decompressive laminectomy plus fusion with unilateral biportal endoscopic technique for single level lumbar spinal stenosis. Asian J Surg 2024:S1015-9584(24)00065-4. [PMID: 38246788 DOI: 10.1016/j.asjsur.2024.01.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/19/2023] [Accepted: 01/05/2024] [Indexed: 01/23/2024] Open
Abstract
PURPOSE This study aimed to compare and analyze the effectiveness of unilateral biportal endoscopic (UBE) decompressive laminectomy plus fusion and microscope-assisted open decompressive laminectomy plus fusion. METHODS A total of 143 patients with lumbar spinal stenosis were enrolled in this study between March 2020 and February 2021 with a minimum 2 years follow-up visit to our hospital. Sixty-five patients underwent the unilateral biportal endoscopic technique and were assigned to the UBE group, and the remaining 78 patients with microscope assistant were assigned to the Microscope group. The baseline characteristics, clinical outcomes, and radiological data were retrospectively collected and analyzed, as well as Clinical outcomes, radiological data and complications. RESULTS There were no significant differences between the two groups in terms of baseline characteristics (P > 0.05). The UBE group was demonstrated to be significantly superior in CRP, drainage, blood loss, treatment cost and Hospital stay than the Microscope group (P < 0.05), whereas a significant longer operation time was observed (P < 0.05). The VAS-B, ODI, and JOA-L scores of the UBE group at 1 year follow-up were significantly greater than those of the Microscope group (P < 0.05). Regarding radiological data, there were no significant differences in the section area of the spinal canal and fusion grade between the two groups (P > 0.05). CONCLUSION In view of the satisfactory clinical outcomes of patients and notable decompression at the stenosed segment, UBE is a feasible, minimally invasive technique for single level lumbar canal stenosis.
Collapse
Affiliation(s)
- Dingli Xu
- Medical School, Ningbo University, Ningbo, 315100, Zhejiang, China
| | - Wubin Shu
- Ningbo Yinzhou No. 2 Hospital, Ningbo, 315100, Zhejiang, China
| | - Leidong Lian
- Medical School, Ningbo University, Ningbo, 315100, Zhejiang, China
| | - Weiyu Jiang
- Ningbo No.6 Hospital, Ningbo, 315100, Zhejiang, China
| | - Xudong Hu
- Ningbo No.6 Hospital, Ningbo, 315100, Zhejiang, China
| | - Kaifeng Gan
- The Affiliated Lihuili Hospital of Ningbo University, Ningbo, 315100, Zhejiang, China.
| | - Weihu Ma
- Ningbo No.6 Hospital, Ningbo, 315100, Zhejiang, China.
| |
Collapse
|
3
|
Takebayashi K, Fujita M, Inui T, Oshima Y, Iwai H, Inanami H, Koga H. Large-Scale Comparative Study Between Microendoscopic Laminectomy and Full-Endoscopic Laminectomy for the Treatment of Single-Level Lumbar Spinal Canal Stenosis. Cureus 2024; 16:e52842. [PMID: 38406165 PMCID: PMC10884873 DOI: 10.7759/cureus.52842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2024] [Indexed: 02/27/2024] Open
Abstract
BACKGROUND We previously compared the operative outcomes of microendoscopic laminectomy (MEL) and full-endoscopic laminectomy (FEL) for single-level lumbar spinal canal stenosis (LSCS). In this initial report, the operative outcomes of FEL were not inferior to those of MEL. OBJECTIVE The purpose of this study is to compare the outcomes of MEL and FEL for single-level LSCS on a large scale using widely used multiple evaluation methods. METHODS MEL was performed using a 16 mm tubular retractor and an endoscope, while FEL was performed using a 6.4 mm working channel endoscope. A retrospective study was performed on patients with LSCS treated with MEL (n = 355) or FEL (n = 154). Patient background and operative data were also collected. The Oswestry Disability Index (ODI), European Quality of Life-5 Dimensions (EQ-5D), and 36-item Short Form Survey (SF-36) scores were recorded preoperatively and 1-year postoperatively. RESULTS Background data of the two groups and the mean operation time (MEL, 72.1 m; FEL, 74.2 m) were not significant (p>0.2). The mean volumes of intraoperative bleeding (MEL, 25.2 ml; FEL, 10.3 ml) were significantly different (p<0.001). The mean postoperative hospital stays (MEL, 3.9 days; FEL, 2.1 days) were significantly different (p<0.001). Fifteen dural tears (MEL, 11; FEL, 4) and 1 surgical site infection (MEL, 1; FEL, 0) were observed but not significant (p>0.5). Reoperation was required for postoperative hematoma in five patients (MEL, 3; FEL, 2). Although the ODI, EQ-5D, and SF-36 scores improved significantly at one year postoperatively in the MEL and FEL groups (p<0.001), there were no significant differences between the two groups (p>0.1). CONCLUSION The operative outcomes and minimal invasiveness were no statistical difference between the MEL and FEL groups. Further development of the operative techniques and the instruments of FEL are required to shorten the operation time.
Collapse
Affiliation(s)
| | - Muneyoshi Fujita
- Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, JPN
| | - Takahiro Inui
- Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, JPN
| | | | - Hiroki Iwai
- Spine Surgery, Iwai Orthopaedic Hospital, Tokyo, JPN
| | - Hirohiko Inanami
- Orthopaedic Surgery, Inanami Spine and Joint Hospital, Tokyo, JPN
| | - Hisashi Koga
- Neurosurgery, Iwai Orthopaedic Medical Hospital, Tokyo, JPN
| |
Collapse
|
4
|
Tan H, Yu L, Xie X, Liu N, Zhang G, Li X, Yang Y, Zhu B. Consecutive Case Series of Uniportal Full-endoscopic Unilateral Laminotomy for Bilateral Decompression in Lumbar Spinal Stenosis: Relationship between Decompression Range and Functional Outcomes. Orthop Surg 2023; 15:3153-3161. [PMID: 37853983 PMCID: PMC10693994 DOI: 10.1111/os.13928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/23/2023] [Accepted: 09/26/2023] [Indexed: 10/20/2023] Open
Abstract
OBJECTIVE Uniportal full-endoscopic unilateral laminotomy for bilateral decompression (UFE-ULBD) has been used to treat lumbar spinal stenosis (LSS) with satisfactory outcomes. However, a limited number of studies have investigated the relationship between decompression range and clinical outcomes. This study aimed to investigate the efficacy of UFE-ULBD for single-segment LSS and to explore the relationship between the decompression range and functional outcomes. METHODS Single-segment LSS patients who had undergone UFE-ULBD using an interlaminar approach between November 2021 and February 2023 were retrospectively analyzed. Patient demographics, visual analogue scale (VAS) scores for leg and back pain, Oswestry disability index (ODI) scores, modified MacNab grades, and radiological outcomes, including the decompression ratio of the disc-flava ligament space and osseous lateral recess, the enlargement ratio of superior articular process interval, lamina interval dural sac cross-sectional area (DSCA), were collected. The independent sample t-tests, paired sample t-tests, chi-square tests, Fisher's exact tests, and Pearson's and Spearman's correlation analyses were used. RESULTS Forty patients (23 males, and 17 females) were retrospectively enrolled in this study. The mean follow-up period was 12 months. At the last follow-up, VAS scores for leg pain and back pain decreased from 6.0 ± 0.8 to 1.0 ± 1.9 (p < 0.001), and from 6.0 ± 0.8 to 1.2 ± 1.8 (p < 0.001) respectively; ODI score decreased from 71.7 ± 6.2 to 24.3 ± 21.3 (p < 0.001). According to the modified MacNab criteria, the results were excellent in 28 (70%), good in 5 (12.5%), fair in 6 (15%), and poor in 1 (2.5%), with an excellent-good rate of 82.5%. The postoperative DSCA enlarged from 57.69 ± 21.86 to 150.75 ± 39.33 mm2 (p < 0.001), with an enlargement ratio of 189.43 ± 107.83%. No difference in clinical or radiological parameters was detected between patients with excellent, good, fair, or poor outcomes based on the modified MacNab criteria. CONCLUSION UFE-ULBD can provide satisfactory clinical and radiological outcomes in single-segment LSS patients. With sufficient exposure to the dural sac boundary, the functional outcome was not related to the radiological decompression range in LSS patients who had undergone UFE-ULBD.
Collapse
Affiliation(s)
- Haining Tan
- Department of OrthopedicsBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
| | - Lingjia Yu
- Department of OrthopedicsBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
| | - Xuehu Xie
- Department of OrthopedicsBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
| | - Ning Liu
- Department of OrthopedicsBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
| | - Guoqiang Zhang
- Department of OrthopedicsBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
| | - Xiang Li
- Department of OrthopedicsBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
| | - Yong Yang
- Department of OrthopedicsBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
| | - Bin Zhu
- Department of OrthopedicsBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
| |
Collapse
|
5
|
Kotheeranurak V, Tangdamrongtham T, Lin GX, Singhatanadgige W, Limthongkul W, Yingsakmongkol W, Kim JS, Jitpakdee K. Comparison of full-endoscopic and tubular-based microscopic decompression in patients with lumbar spinal stenosis: a randomized controlled trial. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2023; 32:2736-2747. [PMID: 37010607 PMCID: PMC10068229 DOI: 10.1007/s00586-023-07678-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 11/21/2022] [Accepted: 03/23/2023] [Indexed: 04/04/2023]
Abstract
PURPOSE We aimed to demonstrate non-inferiority in terms of functional outcomes in patients with lumbar spinal stenosis who underwent full-endoscopic decompression compared with tubular-based microscopic decompression. METHODS This prospective, randomized controlled, non-inferiority trial included 60 patients with single-level lumbar spinal stenosis who required decompression surgery. The patients were randomly assigned in a 1:1 ratio to the full-endoscopic group (FE group) or the tubular-based microscopic group (TM group). Based on intention-to-treat analysis, the primary outcome was the Oswestry Disability Index score at 24 months postoperative. The secondary outcomes included the visual analog scale (VAS) score for back and leg pain, European Quality of Life-5 Dimensions (EQ-5D) score, walking time, and patient satisfaction rate according to the modified MacNab criteria. Surgery-related outcomes were also analyzed. RESULTS Of the total patients, 92% (n = 55) completed a 24-month follow-up. The primary outcomes were comparable between the two groups (p = 0.748). However, the FE group showed a statistically significant improvement in the mean VAS score for back pain at day 1 and at 6, 12, and 24 months after surgery (p < 0.05). No significant difference was observed in the VAS score for leg pain, EQ-5D score, or walking time (p > 0.05). Regarding the modified MacNab criteria, 86.7% of patients in the FE group and 83.3% in the TM group had excellent or good results at 24 months after surgery (p = 0.261). Despite the similar results in surgery-related outcomes, including operative time, radiation exposure, revision rate, and complication rate, between the two groups (p > 0.05), less blood loss and shorter length of hospital stay were observed in the FE group (p ≤ 0.001 and 0.011, respectively). CONCLUSION This study suggests that full-endoscopic decompression is an alternative treatment for patients with lumbar spinal stenosis because it provides non-inferior clinical efficacy and safety compared with tubular-based microscopic surgery. In addition, it offers advantages in terms of less invasive surgery. Trial registration number (TRN): TCTR20191217001.
Collapse
Affiliation(s)
- Vit Kotheeranurak
- Department of Orthopaedic, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence in Biomechanics and Innovative Spine Surgery, Chulalongkorn University, Bangkok, Thailand
| | | | - Guang-Xun Lin
- Department of Orthopedics, School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen University, Xiamen, Fujian China
- The Third Clinical Medical College, Fujian Medical University, Fuzhou, Fujian China
| | - Weerasak Singhatanadgige
- Department of Orthopaedic, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence in Biomechanics and Innovative Spine Surgery, Chulalongkorn University, Bangkok, Thailand
| | - Worawat Limthongkul
- Department of Orthopaedic, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence in Biomechanics and Innovative Spine Surgery, Chulalongkorn University, Bangkok, Thailand
| | - Wicharn Yingsakmongkol
- Department of Orthopaedic, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence in Biomechanics and Innovative Spine Surgery, Chulalongkorn University, Bangkok, Thailand
| | - Jin-Sung Kim
- Spine Center, Department of Neurosurgery, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Khanathip Jitpakdee
- Department of Orthopedics, Queen Savang Vadhana Memorial Hospital, Sriracha, Chonburi, Thailand
| |
Collapse
|
6
|
Liu Y, Li X, Hou Y, Leng X, Yan M, Chen X, Huang H, Xu Y. Surgical outcomes of percutaneous endoscopic thoracic decompression in the treatment of multi-segment thoracic ossification of the ligamentum flavum. Acta Neurochir (Wien) 2023; 165:2131-2137. [PMID: 37166509 DOI: 10.1007/s00701-023-05603-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 04/18/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND Previous studies have demonstrated satisfactory outcomes of percutaneous endoscopic thoracic decompression (PETD) for single-segment thoracic ossification of the ligamentum flavum (TOLF). However, the clinical outcomes of PETD in patients with multi-segment TOLF (mTOLF) remain unclear. The aim of the present study was to evaluate the efficacy and safety of PETD for patients with multi-segment mTOLF. METHODS Eighteen consecutive patients (41 segments) with mTOLF were treated with PETD between January 2020 and December 2021. The clinical outcomes were evaluated using the modified Japanese Orthopaedic Association (mJOA) score and Visual Analog Scale (VAS), whereas radiographic parameters were measured by cross-section area of the spinal canal and anteroposterior diameter of the spinal cord. RESULTS The follow-up period ranged from 14 to 34 months. The mean operation time and blood loss were 154.06 ± 32.14 min and 61.72 ± 12.72 ml, respectively. Hospital stay after first-stage operation was 10.89 ± 2.42 days. The mJOA score and VAS score significantly improved at the final follow-up, with a mean mJOA recovery rate of 63.3 ± 21.90%. The incidence of complications was 12.2% per level. The radiographic outcomes showed adequate decompression of the spinal cord. CONCLUSIONS The present study demonstrates that PETD is effective and safe as a minimally invasive procedure to treat patients with mTOLF. All patients showed relief of their symptoms and improvement in neurological function.
Collapse
Affiliation(s)
- Yunxuan Liu
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Xingchen Li
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
- Changchun University of Chinese Medicine, Changchun, 130117, China.
| | - Yingying Hou
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Xiangyang Leng
- Changchun University of Chinese Medicine, Changchun, 130117, China
| | - Ming Yan
- The Third Affiliated Clinical Hospital of Changchun University of Chinese Medicine, Changchun, 130118, China
| | - Xiaoxin Chen
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Honghan Huang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Yusheng Xu
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| |
Collapse
|
7
|
Huang X, Wang W, Chen G, Guan X, Zhou Y, Tang Y. Comparison of surgical invasiveness, hidden blood loss, and clinical outcome between unilateral biportal endoscopic and minimally invasive transforaminal lumbar interbody fusion for lumbar degenerative disease: a retrospective cohort study. BMC Musculoskelet Disord 2023; 24:274. [PMID: 37038129 PMCID: PMC10088165 DOI: 10.1186/s12891-023-06374-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 03/26/2023] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND Currently, hidden blood loss (HBL) has been paid more and more attention by spine surgeons. Simultaneously, it has been the effort of spine surgeons to explore more advantages of minimally invasive surgery. More and more articles have compared unilateral biportal endoscopic lumbar interbody fusion (BE-LIF) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). But so far, there is no HBL comparison between BE-LIF and MIS-TLIF. This study aims to compare the surgical invasiveness, hidden blood loss, and clinical outcome of BE-LIF and MIS-TLIF and to provide insight regarding minimally invasive surgery for lumbar degenerative disease (LDD). METHODS We enrolled 103 eligible patients with LDD who underwent BE-LIF (n = 46) and MIS-TLIF (n = 57) during August 2020-March 2021. We collected data, including demographics, perioperative haematocrit, operative and postoperative hospital times, serum creatine kinase (CK) and C-reactive protein (CRP) levels, and hospitalization costs. Total and hidden blood loss was calculated. Clinical outcomes were assessed using a visual analogue scale (VAS) score for back and leg pain, Oswestry Disability Index (ODI), modified MacNab criteria, fusion rate, and complications. RESULTS Basic demographics and surgical data were comparable. The CRP and CK levels were generally lower in the BE-LIF than in the MIS-TLIF group, especially CRP levels on postoperative day (POD) three and CK levels on POD one. True total blood loss, postoperative blood loss, and hidden blood loss were significantly reduced in the BE-LIF group compared with the MIS-TLIF group. Postoperative hospital times was statistically significantly shorter in the BE-LIF group. The VAS pain and ODI scores improved in both groups. At three days and one month, the VAS lower back pain scores were significantly better after BE-LIF. Clinical outcomes did not otherwise differ between groups. CONCLUSIONS Compared with MIS-TLIF, BE-LIF has similar medium and short-term clinical outcomes. However, it is better regarding surgical trauma, early lower back pain, total and hidden blood loss, and recovery time. BE-LIF is an adequate option for selected LDD.
Collapse
Affiliation(s)
- Xinle Huang
- Department of Orthopaedics, The Second Affiliated Xinqiao Hospital of Army Medical University, Chongqing, China
| | - Wenkai Wang
- Department of Orthopaedics, The Second Affiliated Xinqiao Hospital of Army Medical University, Chongqing, China
| | - Guangxing Chen
- Center for Joint Surgery, Southwest Hospital, Army Medical University, Chongqing, China
| | - Xiangchen Guan
- Department of Orthopaedics, The Second Affiliated Xinqiao Hospital of Army Medical University, Chongqing, China
| | - Yue Zhou
- Department of Orthopaedics, The Second Affiliated Xinqiao Hospital of Army Medical University, Chongqing, China.
| | - Yu Tang
- Department of Orthopaedics, The Second Affiliated Xinqiao Hospital of Army Medical University, Chongqing, China.
- Department of Orthopedics, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
| |
Collapse
|
8
|
Chen KT, Kim JS, Huang APH, Lin MHC, Chen CM. Current Indications for Spinal Endoscopic Surgery and Potential for Future Expansion. Neurospine 2023; 20:33-42. [PMID: 37016852 PMCID: PMC10080449 DOI: 10.14245/ns.2346190.095] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 02/15/2023] [Indexed: 04/03/2023] Open
Abstract
Endoscopic spine surgery (ESS) has evolved as a safe, effective, and efficient alternative for minimally invasive spine surgery (MISS). The innovation of full-endoscopic systems makes definitive decompression surgery through different approaches feasible. The approach can be determined according to the location of the target lesion or the surgeon's preference. During the past 2 decades, ESS has expanded its indications from lumbar to cervical spines. Except for decompression, endoscopy-assisted fusion surgery is also developing. However, ESS is still evolving and has a steep learning curve. The revolution of technologies and ESS techniques will enable surgeons to treat various spinal diseases more practically. In recent years, the application of the computer-assisted navigation system and augmented reality have reformed imaging quality and interpretation. The endoscopic rhizotomy techniques have opened a new way for MISS of chronic low back pain. This review introduces the current indications of ESS and its potential future expansion.
Collapse
Affiliation(s)
- Kuo-Tai Chen
- Department of Neurosurgery, Chang Gung Memorial Hospital Chiayi, Chiayi, Taiwan
| | - Jin-Sung Kim
- Department of Neurosurgery, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
| | - Abel Po-Hao Huang
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Martin Hsiu-Chu Lin
- Department of Neurosurgery, Chang Gung Memorial Hospital Chiayi, Chiayi, Taiwan
| | - Chien-Min Chen
- Department of Leisure Industry Management, National Chin-Yi University of Technology, Taichung, Taiwan
- Division of Neurosurgery, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan
- Corresponding Author Chien-Min Chen Division of Neurosurgery, Department of Surgery, Changhua Christian Hospital, No. 135 Nanxiao St., Changhua City, Changhua County 500, Taiwan
| |
Collapse
|