Clinical success of transforaminal endoscopic discectomy with foraminotomy: A retrospective evaluation

Clinical success of transforaminal endoscopic discectomy with foraminotomy: A retrospective... 1 Background</h5> Transforaminal endoscopic lumbar discectomy is a minimally invasive spinal surgery procedure that was introduced by Kambin and Gellman in 1983 [1] . Advances in endoscopic visualization and instrumentation, as well as increased patient demand for more minimally invasive procedures, have lead to an increased popularity of the technique. Transforaminal endoscopic surgery, used in the TESSYS™ method in conjunction with instruments developed by Joimax, incorporates an ‘outside-in’ approach in which the working cannula tip is not positioned inside of the disc space unlike former transforaminal approaches. The cannula is instead positioned in the lower portion of the neuroforamina into the epidural space and positioned under fluoroscopic guidance directly at the site of the herniation [2] .</P>Paramount to the success of an endoscopic discectomy is the experience and technical ability of the surgeon to identify, visualize, and physically access the herniation [3] . Identification of the most offending lumbar level is localized through review of medical history and dermatomal distribution of pain. Central, paramedian or far lateral herniation is diagnosed objectively using the patient films such as MRI or CT scan. Radiography facilitates diagnosis of the level with the largest herniation and smallest spinal canal cross-sectional area and/or http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Clinical Neurology and Neurosurgery Elsevier

Clinical success of transforaminal endoscopic discectomy with foraminotomy: A retrospective evaluation

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Publisher
Elsevier
Copyright
Copyright © 2013 Elsevier B.V.
ISSN
0303-8467
DOI
10.1016/j.clineuro.2013.05.033
Publisher site
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Abstract

1 Background</h5> Transforaminal endoscopic lumbar discectomy is a minimally invasive spinal surgery procedure that was introduced by Kambin and Gellman in 1983 [1] . Advances in endoscopic visualization and instrumentation, as well as increased patient demand for more minimally invasive procedures, have lead to an increased popularity of the technique. Transforaminal endoscopic surgery, used in the TESSYS™ method in conjunction with instruments developed by Joimax, incorporates an ‘outside-in’ approach in which the working cannula tip is not positioned inside of the disc space unlike former transforaminal approaches. The cannula is instead positioned in the lower portion of the neuroforamina into the epidural space and positioned under fluoroscopic guidance directly at the site of the herniation [2] .</P>Paramount to the success of an endoscopic discectomy is the experience and technical ability of the surgeon to identify, visualize, and physically access the herniation [3] . Identification of the most offending lumbar level is localized through review of medical history and dermatomal distribution of pain. Central, paramedian or far lateral herniation is diagnosed objectively using the patient films such as MRI or CT scan. Radiography facilitates diagnosis of the level with the largest herniation and smallest spinal canal cross-sectional area and/or

Journal

Clinical Neurology and NeurosurgeryElsevier

Published: Oct 1, 2013

References

  • Percent spinal canal compromise on MRI utilized for predicting the need for surgical treatment in single-level lumbar intervertebral disc herniation
    Carlise, E.; Luna, M.; Tsou, P.M.; Wang, J.C.

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