Contemporary Endoscopic Spine Surgery brings the reader the most up-to-date information on the endoscopy of the spine. Key opinion leaders from around the world have come together to present the clinical evidence behind their competitive endoscopic spinal surgery protocols. Chapters in the series cover a range of aspects of spine surgery including spinal pain generators, preoperative workup with modern independent predictors of favorable clinical outcomes with endoscopy, anesthesia in an outpatient setting, management of complications, and a fresh look at technology advances in a historical context. The reader will have a first-row seat during the illustrative discussions of expanded surgical indications from herniated disc to more complex clinical problems, including stenosis, instability, and deformity in patients with advanced degenerative disease of the human spine. Contemporary Endoscopic Spine Surgery is divided into three volumes: Cervical Spine, Lumbar Spine, and Advanced Technologies to capture an accurate snapshot in time of this fast-moving field.
It is intended as a comprehensive go-to reference text for surgeons in graduate residency and postgraduate fellowship training programs and for practicing spine surgeons interested in looking for the scientific foundation for their practice expansion into endoscopic surgery.This volume (Lumbar Spine) covers the following topics in 18 detailed chapters:Lumbar endoscopy: historical perspectives, present & futureEndoscopic lumbar discectomy – anatomy, nomenclature, indications and advanced techniquesCurrent approaches for the treatment of endstage vacuum degenerative lumbar disc diseaseAdvanced endoscopic techniques of lumbar foraminotomy and treatment of degenerative spondylolisthesisEndoscopic treatment of lumbar facet cystsEndoscopic techniques for the treatment of a wide range of chronic low back painEndoscopic spine surgery techniques in the elderlyEndoscopic fusion techniquesEndoscopic resection of schwannomaTechnical notes for difficult cases, controversies and complications of lumbar endoscopy.
It is intended as a comprehensive go-to reference text for surgeons in graduate residency and postgraduate fellowship training programs and for practicing spine surgeons interested in looking for the scientific foundation for their practice expansion into endoscopic surgery.This volume (Lumbar Spine) covers the following topics in 18 detailed chapters:Lumbar endoscopy: historical perspectives, present & futureEndoscopic lumbar discectomy – anatomy, nomenclature, indications and advanced techniquesCurrent approaches for the treatment of endstage vacuum degenerative lumbar disc diseaseAdvanced endoscopic techniques of lumbar foraminotomy and treatment of degenerative spondylolisthesisEndoscopic treatment of lumbar facet cystsEndoscopic techniques for the treatment of a wide range of chronic low back painEndoscopic spine surgery techniques in the elderlyEndoscopic fusion techniquesEndoscopic resection of schwannomaTechnical notes for difficult cases, controversies and complications of lumbar endoscopy.
Table of Contents
PREFACE- i LIST OF CONTRIBUTORS
CHAPTER 1 LUMBAR ENDOSCOPY: HISTORICAL PERSPECTIVES, PRESENT & FUTURE
- Kai-Uwe Lewandrowski, Jin-Sung Kim, Friedrich Tieber and Anthony Yeung INTRODUCTION
- THE TRANSFORMATION
- HISTORY PERSPECTIVES OF ENDOSCOPIC SPINAL SURGERY
- THE NITZE-LEITER MUSEUM FOR ENDOSCOPY
- THE EVOLUTION OF LASERS IN SPINAL ENDOSCOPY
- RADIOFREQUENCY ABLATION
- NEW LANDMARK CLINICAL OUTCOME STUDIES
- THE ASIAN LEADERSHIP ROLE
- CONCLUSION
- CONSENT FOR PUBLICATION
- CONFLICT OF INTEREST
- ACKNOWLEDGEMENT
- REFERENCES
CHAPTER 2 ENDOSCOPIC LUMBAR DISCECTOMY – ANATOMY, INDICATIONS AND TECHNIQUES
- Ji-Yeon Kim, Hyeun sung Kim, Kai-Uwe Lewandrowski and Tae Jang INTRODUCTION
- ANATOMICAL CONSIDERATIONS
- Anatomical Classification of Percutaneous Endoscopic Approach (Fig. 1) [27]
- Types of Percutaneous Endoscopic Lumbar Discectomy System Working Channel (Fig. 3) 30 DIAGNOSIS
- PREPARATION
- Set-up
- Position
- ANESTHESIA
- < Anesthetic Methods for Percutaneous Endoscopic Lumbar Discectomy >
- DISCUSSION
- CONCLUSION
- CONSENT FOR PUBLICATION
- CONFLICT OF INTEREST
- ACKNOWLEDGEMENT
- REFERENCES
CHAPTER 3 PATIENT REPORTED OUTCOME MEASURES, NOMENCLATURE & CLASSIFICATIONS IN CLINICAL RESEARCH OF ENDOSCOPIC SPINE SURGERY
- Kai-Uwe Lewandrowski, Álvaro Dowling, Said G Osman, Jin-Sung Kim, Stefan Hellinger, Nimar Salari, Rômulo Pedroza Pinheiro, Ramon Torres and Anthony Yeung INTRODUCTION
- WIDELY USED CLINICAL OUTCOME TOOLS
- MINIMAL CLINICALLY IMPORTANT DIFFERENCE SCORE
- ENDOSCOPIC CLASSIFICATION OF STENOSIS
- THE NOMENCLATURE MAZE
- LUMBAR DISEASE CLASSIFICATION FOR ENDOSCOPIC SPINE SURGERY
- DISCUSSION
- CONCLUSION
- CONSENT FOR PUBLICATION
- CONFLICT OF INTEREST
- ACKNOWLEDGEMENT
- REFEERENCES
CHAPTER 4 TRANSFORAMINAL PERCUTANEOUS ENDOSCOPIC LUMBAR DISCECTOMY
- Ji-Yeon Kim, Hyeun sung Kim, Kai-Uwe Lewandrowski and Il-Tae Jang INTRODUCTION
- INDICATIONS AND APPLICATIONS
Indications for Difficult Cases of Percutaneous Endoscopic Lumbar Discectomy
General Structural Anatomy: Posterolateral PELD Approach
General Operative Anatomy: Posterolateral PELD Approach
- Operative Anatomical Structures in PELD
Exiting Nerve Root Approach
Traversing Nerve Root Approach
Operative Safety Zone Anatomy
SURGICAL PITFALLS
1. Position of the Working Cannula
2. Anatomical Limitation
- - Foraminal Space
- - Iliac Crest
TECHNIQUES FOR AN INFERIOR MIGRATED DISC
1. Epidural Exposure
1.1. Extreme Lateral Approach [2]
1.2. Suprapedicular Approach
1.3. Foraminoplastic Technique
1.4. Contralateral approach [45]
2. Entry Point
2.1. MRI Length Measurement Method
2.2. MRI Marker Method
- 10. INTRAOPERATIVE EXAMINATION METHOD
- 11. PROCEDURAL STEPS
- 11.1. Positioning & Skin Marking
- 11.2. Skin Incision & Anesthesia
- 11.3. Needle Insertion & Provocative Chromodiscography
- 11.4. Guide Needle Insertion
- 11.5. Evocative Chromodiscography
- 11.6. Working Cannula Insertion
- 11.7. Working Cannula Placement
- 11.7.1. Outside-In Approach
- 11.7.2. Inside-Out Approach
- 11.8. Decompressive Discectomy
- 11.8.1. Foraminal Work
- 11.8.2. Annulus Fenestration
- 11.8.3. Discectomy
- 11.9. Assessing the Decompression
- 11.9.1. Exiting Root Approach
- 11.9.2. Epidural Central Approach
- 11.9.3. Epidural Inferior Approach
- 11.9.4. Major Concerns in the PELD for Inferior Migrated Disc
- DISCUSSION
- CONCLUSION
- CONSENT FOR PUBLICATION
- CONFLICT OF INTEREST
- ACKNOWLEDGEMENTS
- REFERENCES
CHAPTER 5 STRUCTURAL PRESERVATION INTERLAMINAR ENDOSCOPIC LUMBAR DISCECTOMY (IELD) FOR L5-S1 HERNIATED DISC
- Ravindra Singh, Hyeun Sung Kim and Il-Tae Jang INTRODUCTION
- ANATOMY & RATIONALE
- THE CONCEPT OF V-POINTS
- PRESERVATION OF THE MOTION SEGMENT
- SURGICAL STEPS
- Ipsilateral Discectomy Technique
- Indications
- Anaesthesia
- Position
- Discography
- Skin Incision & Markings
- Docking of Working Channel and Endosope
- Splitting of Lgamentum Flavum
- Discectomy
- Annular Sealing
- Skin Closure
- Contraleteral Discectomy Technique
- Indications
- Anaesthesia
- Position
- Discography
- Skin Incision & Markings
- Docking of Working Channel and Endoscope
- Ligamentum Flavum Splitting
- Discectomy
- Annular Sealing
- Skin Closure
- POTENTIAL RISKS
- Dural Tear
- Incomplete Discectomy
- Nerve Root Injury
- Epidural Hematoma
- Infection
- Recurrence
- Less Common Complications
- POSTOPERATIVE AND REHABILITATION PROTOCOL
- CLINICAL SERIES
- DISCUSSION
- TECHNICAL PEARLS
- CONCLUSION
- CONSENT FOR PUBLICATION
- CONFLICT OF INTEREST
- ACKNOWLEDGEMENT
- REFERENCES
CHAPTER 6 HYBRIDIZED INSIDE-OUT/OUTSIDE-IN APPROACH FOR TREATMENT OF ENDSTAGE VACUUM DEGENERATIVE LUMBAR DISC DISEASE
- Kai-Uwe Lewandrowski and Anthony Yeung INTRODUCTION
- TECHNIQUE DESCRIPTION
Patient Positioning
Access Planning and Marking
Local Anesthesia & Monitored Anesthesia Care (MAC) Sedation
Placement of the Working Cannula
Initial Foraminoplasty
- OUTSIDE-IN PORTION
Target the Center of the Disc Space
- INSIDE-OUT PORTION
- . Intradiscal Assessment of Painful Pathology
- CLINICAL SERIES
- DISCUSSION
- CONCLUSION
- CONSENT FOR PUBLICATION
- CONFLICT OF INTEREST
- ACKNOWLEDGEMENT
- REFERENCES
CHAPTER 7 FULL ENDOSCOPIC INTERLAMINAR CONTRA-LATERAL LUMBAR FORAMINOTOMY
- Harshavardhan Dilip Raorane, Hyeun-Sung Kim and Il-Tae Jang INTRODUCTION
- SURGICAL ANATOMY
- SURGICAL INDICATIONS
- CONTRAINDICATIONS
- SURGICAL TECHNIQUE
- Preoperative Planning
- Anaesthesia
- Patient Preparation & Position
- Surface Marking & Docking
- Contralateral Approach
- Foraminal & Extraforaminal Decompression
- Final Check
- Postoperative Protocol
- CLINCIAL SERIES
Author
- Kai-Uwe Lewandrowski
- Jorge Felipe Ramírez León
- Anthony Yeung
- Hyeun-Sung Kim
