Journal of Minimally Invasive Spine Surgery and Technique最新文献

{"title":"Full-Endoscopic Discectomy and Debridement for Iatrogenic Spondylodiscitis After a Lumbar Peritoneal Shunt","authors":"Chien-Li Huang, Jiun-Yi Huang, Chien-Min Chen, Jae Hwan Lee","doi":"10.21182/jmisst.2023.01137","DOIUrl":"https://doi.org/10.21182/jmisst.2023.01137","url":null,"abstract":"a","PeriodicalId":405058,"journal":{"name":"Journal of Minimally Invasive Spine Surgery and Technique","volume":"53 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140662116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy and Clinical Outcomes of Fluoroscopy-Guided and Robotic-Assisted Percutaneous Pedicle Screw Fixation Performed by a Single Surgeon at a Single Center","authors":"Jong Hyeok Lee, D. Son, Bu Kwang Oh, Jun Seok Lee, Su Hun Lee, Young Ha Kim, Soon-Ki Sung, Sang Weon Lee, Geun Sung Song, Chang Hyeun Kim, Chi Hyung Lee, Seong Yi","doi":"10.21182/jmisst.2024.01172","DOIUrl":"https://doi.org/10.21182/jmisst.2024.01172","url":null,"abstract":"Objective: Fluoroscopy-guided percutaneous pedicle screw fixation (FGPSF) and its further development, robot-assisted percutaneous pedicle screw fixation (RAPSF), are minimally invasive spinal surgery (MISS) techniques. FGPSF is a standard technique at our hospital, and RAPSF incorporating artificial intelligence has been performed at our hospital since October 2021. This study compared these 2 techniques and analyzed their differences, accuracy, and clinical outcomes based on our experiences. Methods: This study conducted a detailed analysis of screw accuracy and the clinical outcomes of 2 MISS techniques, FGPSF, and RAPSF. Screw accuracy was evaluated using the Gertzbein and Robbins scale, categorizing placements into grades A–E, with grades A and B considered clinically acceptable. Accuracy was assessed using postoperative computed tomography images for FGPSF and intraoperative O-arm scan images for RAPSF. Clinical outcomes were compared by examining parameters, such as hospitalization duration, C-reactive protein (CRP) normalization period, estimated blood loss (EBL), and preoperative/postoperative visual analogue scale (VAS) scores. Screw-related complications were reviewed. Independent image evaluations by nonparticipating spine specialists ensured objective and reliable assessments. Results: Both FGPSF and RAPSF demonstrated high rates of clinically acceptable screw placement, with minimal breaches that required no repositioning. The clinically acceptable rates of FGPSF and RAPSF were similar (99.17% and 99.19%, respectively). Both groups also demonstrated similar clinical outcomes. The CRP normalization period, EBL, and ΔVAS (preoperative— postoperative) scores revealed no statistically significant differences between FGPSF and RAPSF. Neither group experienced screw-related complications; however, the RAPSF group exhibited a statistically significant shorter hospital stay than the FGPSF group. Conclusion: This study compared the accuracy and clinical outcomes of FGPSF and RAPSF. Both methods demonstrated no significant differences in accuracy or clinical outcomes. Spine surgeons selected between the 2 methods based on individual patient needs, and additional research is required to fully understand the practical advantages of each technique in the clinical field.","PeriodicalId":405058,"journal":{"name":"Journal of Minimally Invasive Spine Surgery and Technique","volume":"2 24","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140664701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preliminary Outcomes of Patients with Lumbar Disc Herniation Undergoing Unilateral Biportal Endoscopic Spine Surgery: A Single-Center Retrospective Study in Vietnam","authors":"Tran Vu Hoang Duong, Pham Anh Tuan, Pham Quoc Linh, Le Tan Bao, Huynh Van Vu, Chu Van Lam, Le Tan Linh, Vo Anh Hung, Phan Duy","doi":"10.21182/jmisst.2023.01046","DOIUrl":"https://doi.org/10.21182/jmisst.2023.01046","url":null,"abstract":"Objective: Unilateral biportal endoscopic (UBE) treatment for lumbar disc herniation (LDH) is an advanced surgical procedure that has recently gained popularity. Numerous reports from developed countries have demonstrated the effectiveness of this minimally invasive technique. We evaluated the initial outcomes of UBE at a healthcare facility with limited resources. Methods: Clinical and radiographic data of 82 patients with LDH treated between July 2022 and June 2023 using UBE discectomy techniques, including the ipsilateral interlaminar approach, contralateral sublaminar approach, and paraspinal approach, were reviewed. Outcomes were analyzed in terms of the modified MacNab criteria, Japanese Orthopaedic Association (JOA) score, and visual analogue scale (VAS), with a mean follow-up of 3.1 months. Results: At the final follow-up, the mean VAS for low back pain improved from 4.5±1.0 to 1.2±0.4 and the VAS for leg pain improved from 7.8±0.9 to 1.6±0.5. The mean JOA score improved from 13.5±2.4 to 24.2±2.1. The modified MacNab criteria were excellent in 56 patients (68.3%), good in 22 (26.9%), and fair in 4 (4.8%). In total, 106 levels of LDH were treated. L4–5 disc herniation was performed in 55 patients (51.9%), L5–S1 in 36 (34.0%), L3–4 in 8 (7.5%), L2–3 in 6 (5.7%), and L1–2 in 1 (0.9%). The ipsilateral interlaminar approach was performed in 93 patients (87.7%), the contralateral sublaminar approach in 7 (6.6%), and the paraspinal approach in 6 (5.7%). Operative time significantly improved after performing 20 cases. In the early stage (1–20 cases), the operation time per level was 102.0±28.2 min, while in the next stage (21–82 cases) it was 78.1±20.4 minutes. No serious complications, including cauda equine syndrome or root palsy, were observed. Three patients had dural tears (2.8%), and 1 had epidural hematoma (0.9%). Conclusion: UBE discectomy may be performed safely and effectively for the treatment of LDH in limited-resource settings.","PeriodicalId":405058,"journal":{"name":"Journal of Minimally Invasive Spine Surgery and Technique","volume":"89 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140370881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Full-Endoscopic Extraforaminal Approach for Extraforaminal Herniated Intervertebral Disc Disease: Exploring Challenging Case","authors":"Jae Hwan Lee, Kai-Sheng Chang, Li-Wei Sun, Kuo-Tai Chen, Chien-Min Chen","doi":"10.21182/jmisst.2023.01011","DOIUrl":"https://doi.org/10.21182/jmisst.2023.01011","url":null,"abstract":"Extraforaminal lumbar disk herniation (E-LDH) constitutes a challenging subset of lumbar disk herniations. Minimally invasive methods like full-endoscopic lumbar discectomy provide benefits but carry risks of complications, such as postoperative dysesthesia and nerve root injury. A 62-year-old male with comorbidities presented with severe leg pain due to left L3/4 E-LDH. An L3 nerve block, guided by fluoroscopy, was performed with the patient in a right decubitus position. After alleviating the pain, the patient was placed in a prone position to undergo the extraforaminal full-endoscopic procedure under local anesthesia. The tip of the needle was targeted to the base of the superior articular process (SAP). Foraminoplasty was precisely performed with a high-speed diamond burr at the base of the SAP, facilitating the removal of the extraforaminal portion of the herniated disc. The procedure yielded immediate relief (visual analogue scale score reduced from 10 to 0). There was no leg pain or associated back pain at the 6-month follow-up. This approach demonstrates the feasibility of an extraforaminal full-endoscopic technique for E-LDH, overcoming challenges associated with the uncooperative patient due to the severe leg pain. However, the technique demands technical proficiency and warrants further research to establish its broader applicability.","PeriodicalId":405058,"journal":{"name":"Journal of Minimally Invasive Spine Surgery and Technique","volume":"121 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140475442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strategies to Improve Neurological Safety in Full-Endoscopic Lumbar Fusion Surgery: A Comprehensive Review","authors":"Yu-Chia Hsu, Yuan-Fu Liu, Chao-Jui Chang, Yu-Meng Hsiao, Yi-Hung Huang, Keng-Chang Liu, Chien-Min Chen, Cheng-Li Lin","doi":"10.21182/jmisst.2023.01130","DOIUrl":"https://doi.org/10.21182/jmisst.2023.01130","url":null,"abstract":"Full-endoscopic spinal fusion surgery has emerged as a crucial approach for managing lumbar degenerative spinal disease. A significant concern in endoscopic spinal fusion relates to the vulnerability of neural structures, particularly the risk of nerve root injury (NRI). This comprehensive review evaluates the critical importance of preserving neurological integrity during endoscopic spinal fusion procedures, focusing on multifactorial contributors to risk and effective strategies for safeguarding the nerve root. The review thoroughly examines anatomical considerations, surgical techniques, the utilization of specialized intraoperative instrumentation, and intraoperative monitoring as key factors influencing the risk of NRI. Understanding these variables is paramount for minimizing postoperative neurological complications and improving patient outcomes. The article succinctly summarizes the clinical presentation of nerve root injuries and recommends therapeutic interventions. It also discusses strategies for preventing NRI, emphasizing both preoperative considerations and intraoperative measures. This comprehensive review provides spine surgeons with valuable insights, highlighting the significance of meticulous techniques and preventive measures to optimize patient safety and overall surgical success in the context of endoscopic spinal fusion.","PeriodicalId":405058,"journal":{"name":"Journal of Minimally Invasive Spine Surgery and Technique","volume":"815 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140479350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biportal Endoscopic Trans-Kambin Lumbar Interbody Fusion: Surgical Techniques and Treatment Outcomes","authors":"Kuo-Pin Kuo, Dae-Jung Choi","doi":"10.21182/jmisst.2023.01116","DOIUrl":"https://doi.org/10.21182/jmisst.2023.01116","url":null,"abstract":"Objective: Lumbar interbody fusion with cages is a commonly used surgical solution for spinal conditions that do not respond to conservative management. Biportal endoscopic trans-Kambin lumbar interbody fusion (BE-KLIF) is a modern technique that offers several benefits over prior techniques, including early ambulation, reduced postoperative pain, and shorter hospital stays.Methods: This retrospective study enrolled 128 patients who underwent BE-KLIF between March 2018 and August 2022. The primary indications for surgery were segmental lumbar listhetic instability, failed decompression with neuroforamen stenosis, adjacent segment disease, and burst fracture of the lumbar vertebrae. The outcome measures included Oswestry Disability Index (ODI) and visual analogue scale (VAS) scores, and postoperative fusion status at 1 year after the procedure was graded using the Bridwell fusion grading scale.Results: BE-KLIF yielded significant improvements in patient outcomes. Successful fusion was achieved in 91.8% of segments. The mean ODI score was significantly lower at the 1-year follow-up than before the procedure. Similarly, VAS scores for leg and back pain significantly improved after the procedure. Seven early and 3 late postoperative complications were observed. The mean length of hospital stay was shorter for BE-KLIF than for the older transforaminal lumbar interbody fusion technique.Conclusion: BE-KLIF resulted in less bone removal, preservation of the facet joint, facilitation of a more oblique trajectory, and potential for larger cages with wider effacements compared with prior techniques. However, the technique lacks central and contralateral decompression. We recommend performing same-side unilateral laminotomy with bilateral decompression to provide central and contralateral decompression.","PeriodicalId":405058,"journal":{"name":"Journal of Minimally Invasive Spine Surgery and Technique","volume":"321 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140474275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling Evolution: Exploring Endoscopic Interbody Fusion Surgery in Minimally Invasive Spine Surgery — Editorial for the January 2024 Special Issue of JMISST","authors":"Keng-Chang Liu, Koichi Sairyo, J. Pao, Man Kyu Park","doi":"10.21182/jmisst.2024.01186","DOIUrl":"https://doi.org/10.21182/jmisst.2024.01186","url":null,"abstract":"","PeriodicalId":405058,"journal":{"name":"Journal of Minimally Invasive Spine Surgery and Technique","volume":"351 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140472190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally Invasive Transforaminal Lumbar Interbody Fusion with the Space-D Access System","authors":"Nathan J. Nordmann, Matthew W. Weber, Jeffrey Z. Nie, Christopher M. Graves","doi":"10.21182/jmisst.2023.01018","DOIUrl":"https://doi.org/10.21182/jmisst.2023.01018","url":null,"abstract":"The Space-D Access System is a new, minimally invasive surgery (MIS) retractor system that allows spine surgeons to perform transforaminal lumbar interbody fusion (TLIF) with intraoperative navigation. Unlike other retractors, this system allows distraction/compression and lateral retraction. This is the first description of the technical aspects of the Space-D Access System for MIS TLIF since its public debut in May 2021. This study introduces the components and applicability of the Space-D Access System and provides step-by-step instructions with visuals to perform a MIS TLIF using this novel device. The Space-D Access System, StealthStation, CD Horizon Solera Voyager, and an anatomic lumbar spine model were used to demonstrate the steps to successfully perform MIS TLIF. The components and applicability of the Space-D Access System are discussed. Detailed written instructions and visuals are provided in a stepwise fashion to complete MIS TLIF effectively and efficiently. The Space-D Access System is the only multifunctional device that allows tissue retraction and pedicle-to-pedicle distraction/compression while performing MIS TLIF. To our knowledge, this is the first paper to describe the device and its use for MIS TLIF with written instructions and visuals using an anatomic model.","PeriodicalId":405058,"journal":{"name":"Journal of Minimally Invasive Spine Surgery and Technique","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139600297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally Invasive Oblique Retroperitoneal Approach for Extraforaminal Lumbar Schwannoma: Technical Challenges and Literature Review","authors":"Dallas E. Kramer, Shahed Elhamdani, Peter Zaki, Sanjeev Herr, Alexander Yu, Matthew J. Shepard","doi":"10.21182/jmisst.2023.00990","DOIUrl":"https://doi.org/10.21182/jmisst.2023.00990","url":null,"abstract":"Traditional surgical techniques for extradural lumbar schwannomas are associated with considerable morbidity, including spinal instability and injury to the viscera and lumbar plexus. Mini-mally invasive approaches decrease soft tissue damage, blood loss, and postoperative length of stay. For select extraforaminal schwannomas, a minimally invasive lateral transpsoas approach affords a direct surgical corridor. A 53-year-old obese female presented with 1 year of left ilio-psoas weakness and L3 radiculopathy refractory to conservative management. Lumbar spine magnetic resonance imaging revealed a contrast-enhancing mass within the left psoas muscle consistent with an extraforaminal L3 schwannoma. The patient underwent minimally invasive oblique retroperitoneal surgical resection. Intraoperatively, the nerve root was splayed over the superior-lateral portion of the tumor limiting us to subtotal resection with nerve root preservation. The patient had improvement of pain and weakness that persisted at a 3-month follow-up. A minimally invasive lateral/oblique transpsoas approach provides a direct surgical approach for extraforaminal schwannoma. Patient body habitus and the nerve root relationship to the tumor may present limitations for the safe extent of resection.","PeriodicalId":405058,"journal":{"name":"Journal of Minimally Invasive Spine Surgery and Technique","volume":"20 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139600307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Italian Landscape of Spine Endoscopy: Are We Ready for the Challenges of the Future?","authors":"Letizia Dell'aglio, Alessandro Grieco, Jacopo Del Verme, G. Canova, R. Zanata, Enrico Giordan","doi":"10.21182/jmisst.2023.00962","DOIUrl":"https://doi.org/10.21182/jmisst.2023.00962","url":null,"abstract":"Objective: Endoscopic spine surgery is gaining popularity, with efficacy comparable to that of traditional techniques. Apart from Germany, European countries are tentatively beginning to consider endoscopic surgery as a valid alternative to conventional procedures, and Italy is no exception. This survey aimed to reveal which spine surgeons currently use endoscopy in Italy, the levels of their skills, and how they have attained them. Methods: We conducted an online survey of Italian spinal surgeons to gather information about their use of minimally invasive and endoscopic surgery. We collected data on their operating habits, including the percentage of minimally invasive techniques in their practice, the type of workplace, and experience. We also asked surgeons to analyze and resolve 4 cases of degenerative lumbar pathologies. Results: Orthopedists and neurosurgeons in public and private facilities performed endoscopic surgery. One-third of respondents had never tried it, while others encountered it through work-shops or producer presentations. A minority of interviewees considered themselves experts in endoscopic surgery, while more than half had “some” or “no” experience. Among endoscopic surgeons, none had experience in thoracic endoscopy, and only a few had used it for cervical diseases. The majority preferred a non-endoscopic approach when faced with clinical cases. Conclusion: The use and knowledge of endoscopic surgery in Italy are not widespread. Our survey highlights a lack of training in the implementation of techniques that should be recognized as additional tools in addition to the traditional procedures for treating not only lumbar, but also thoracic and cervical pathologies.","PeriodicalId":405058,"journal":{"name":"Journal of Minimally Invasive Spine Surgery and Technique","volume":"35 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139602405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}