This book is a superbly illustrated guide to the latest endoscopic approaches employed in surgery to the lumbar spine. In the past, spinal endoscopic surgeries have been performed mainly in the treatment of lumbar disc herniation, but indications have now expanded owing to breakthroughs in surgical methods and instruments. Furthermore, in addition to the traditional percutaneous transforaminal approach, various other approaches are now feasible, including the posterior, paraspinal, transpedicular, and contralateral. This book describes and illustrates the full array of approaches in indications including lumbar central stenosis, lumbar foraminal stenosis, and lumbar disc herniation. Detailed guidance is also provided on endoscopic lumbar interbody fusion, covering the oblique, uniportal, and biportal approaches. Supplementary surgical videos further facilitate understanding and execution of the described procedures. Written by expert spinal endoscopy surgeons with extensive practical experience and a record of academic achievement, the book will be an ideal aid for spine surgeons at all levels of experience.
Author(s): Hyeun Sung Kim, Michael Mayer, Dong Hwa Heo, Cheol Woong Park
Publisher: Springer Singapore
Year: 2021
Language: English
Pages: 172
City: Singapore
Foreword
Foreword
Foreword
Preface
Acknowledgement
Congratulatory Address
Contents
Part I: Special Issue of Endoscopic Spine Surgery
Paradigm Shifting of Endoscopic Spine Surgery
Introduction
Generations of Endoscopic Spine Surgery
References
Nomenclature of Endoscopic Spine Surgery
Introduction (Key Point and Purpose) of Approach
Understanding and Unifying the Nomenclature
Posterior Endoscopic Cervical Discectomy (PECD) or Foraminotomy (PECF)
Transforaminal Endoscopic Lumbar Discectomy (TELD)
Interlaminar Endoscopic Lumbar Discectomy (IELD)
Lumbar Endoscopic Unilateral Laminotomy for Bilateral Decompression (LE-ULBD)
Endoscopic-Assisted Surgery
Unilateral Biportal Endoscopic (UBE) Surgery
Conclusion
References
Part II: Lumbar Central Stenosis
Full Endoscopic Posterior Approach, In and Out
Introduction (Key Point and Purpose) of Approach
Indication and Contraindication
Anesthesia and Position
Special Surgical Instruments
Surgical Steps (Illustration, Photos, and Video)
Illustrated Case or Cases
Complication and its Management
Brief Discussion: Surgical Tip and Pitfall
References
Full Endoscopic Posterior Approach ‘Out and In’ Technique
Introduction
Advantages
Indications
Contraindications
Anatomical Consideration
Surgical Technique
Preoperative Planning
Plain Radiograph
Magnetic Resonance Imaging (MRI) and CT Scan
Anaesthesia and Position
Special Surgical Instruments
Surgical Steps
Skin Incision
Working Cannula Docking and Insertion of Endoscope
Anatomical Points
Bony Decompression
Removal of the Ligamentum flavum and Confirmation of Decompressed Neural Structures
Postoperative Care
Complications and Management
Intraoperative
Postoperative
Illustrative Cases
Single-Level ESLD
Multilevel ESLD
Discussion (Surgical Tips and Pitfalls)
Limitations
Summary
References
Biportal Endoscopic Approach for Lumbar Central Stenosis
Introduction
Anesthesia and Position
Special Surgical Instruments
Surgical Steps (Illustration, Photos, and Video)
Skin Mark and Incision
Two Portals (Biportal) Making
Soft Tissue Dissection and Laminectomy
Ligamentum Flavum Removal and Decompression of Ipsilateral Traversing Nerve Root (Video 1)
Decompression of Contralateral Traversing Nerve Root (Video 2)
Discectomy and Closure
Illustrated Case or Cases
Complications and its Management
Bleeding
Dural tear
Brief Discussion: Surgical Tip and Pitfall
References
Part III: Lumbar Foraminal Stenosis
Uniportal Full Endoscopic Contralateral Approach for Lumbar Foraminal Stenosis
Introduction
Indication/Contraindication
Anesthesia/Position
Anesthesia
Position
Special Surgical Instrument
Basic Instrument
Special Instrument
Surgical Steps
Anatomical Consideration
Skin Marking/Skin Incision
Skin Marking
Skin Incision
Approach and Docking
Sublaminar Approach Drilling
Detachment of the Ligamentum Flavum
Foraminotomy
Final Confirmation Decompression of Foramen
Illustrative Case Figures
Complication/Management
Discussion
Summary
References
Lumbar Foraminal Stenosis: Full Endoscopic Transforaminal Approach
Introduction (Key Point and Purpose) of Approach
Indication and Contraindication
Indication
Contraindication
Anesthesia and Position
Special Surgical Instruments
Surgical Steps
Illustrated Cases
Case 1
Case 2
Complication and its Management
Brief Discussion: Surgical Tip and Pitfall
References
Full Endoscopic Paraspinal Approach for Lumbar Foraminal Stenosis
Introduction
Indication and Contraindication
Anaesthesia and Position
Surgical Steps
Preoperative Targeting by Needle
Skin Incision
Sequential Dilation and Working Cannula Insertion
Confirmation of Anatomical Landmark and Initial Circumferential Bony Decompression
The Removal of LF and Peri-eural Adhesiolysis
Additional Decompression
Haemostasis and Closure
Illustrated Cases
Case 1: Extraforaminal Disc Herniation
Case 2: Far out Syndrome
Case 3: Severe Foraminal Stenosis
Complications and Its Management
Discussion (Surgical Tips and Pitfalls)
References
Contralateral Sublaminar Approach for Lumbar Foraminal Stenosis Using Biportal Endoscopic Surgery
Introduction
Indication and Contraindication
Indications [5, 6]
Contraindications
Surgical Instruments
Surgical Steps (Videos 1 and 2)
Illustrated Cases
Complication and its Management
Discussion
References
Biportal Endoscopic Paraspinal Approach for Foraminal and Extraforaminal Disc Herniations
Introduction
Indication and Contraindication
Anesthesia and Position
Special Surgical Instruments
Surgical Steps (Illustration, Photos, and Video)
Skin Marking
Making a Portal
Making the Working Space (Video 1)
Bone Working (Video 2) and Removal of the Foraminal Ligament (Video 3)
Removal of Disc/Osteophytes (Video 4)
Illustrated Case or Cases
Complication and its Management
Postoperative Hematoma
Dural Tear
Abdominal Fluid Collection
Discussion
References
Part IV: Lumbar Disc Herniation
Full Endoscopic Approach with Foraminoplasty
Introduction
Indications
Anesthesia and Position
Special Surgical Instruments (Fig. 1)
Surgical Steps
Initial Targeting
Foraminoplasty
Final PELD Procedure
High-Grade Migration/Downward Sequestration
Illustrative Case
Recurrent Disc Herniation
L5-S1 Intracanal Disc Herniation with a High Iliac Crest
Illustrative Case
Central Disc Herniation with a Wide Lamina Angle
Complications and their Management
Brief Discussion: Surgical Tip and Pitfall
References
Full-Endoscopic Transpedicular Approach
Introduction
Anatomy
Indication and Contraindication
Surgical Instruments [8]
Surgical Techniques [8, 9]
How to Avoid Complications
Conclusion
References
Biportal Endoscopic Approach (Biportal Endoscopic Lumbar Discectomy)
Introduction of Approach
Indication and Contraindication
Anesthesia and Position
Special Surgical Instruments (Figs. 2 and 3)
Surgical Steps
Illustrated Cases
Complication and Its Management
Discussion: Surgical Tip and Pitfall
References
Part V: Endoscopic Lumbar Interbody Fusion
Endoscope-Assisted Oblique Lumbar Interbody Fusion
Introduction (Key Point and Purpose) of Approach
Indication
Type of Herniated Nucleus Pulposus (HNP) accessible by Endoscope
Contraindication
Anaesthesia and Position
Special Surgical Instruments
Surgical Steps (Illustration)
Illustrated Case
Complication and its Management
Choosing the Right Operative Strategy
Brief Discussion
Key Points
Benefits of Endoscopic OLIF
References
Endoscopic LIF (Uniportal); Endoscopic TLIF; FELIF (Full Endoscopic Lumbar Interbody Fusion)
Introduction (Key Point and Purpose) of Approach
Indication and Contraindication
Anesthesia and Position
Special Surgical Instruments
Surgical Steps: Summarized with Video File (Video 1)
Illustrated Case or Cases
Case
Limitation, Complication, and its Management
Surgical Tip and Pitfall
References
Biportal Endoscopic Transforaminal Lumbar Interbody Fusion
Introduction
Indication and Contraindication
Anesthesia and Position
Special Surgical Instruments
Surgical Steps (Videos 1 and 2)
Illustrated Case or Cases
Complication and its Management
Brief Discussion (Surgical Tip and Pitfall)
References
