Journal of Minimally Invasive Spine Surgery and Technique最新文献

{"title":"Partial Vertebrectomy in Neglected Spondyloptosis at the T10–11 Level: A Case Report","authors":"Radityo Priambodo, R. Dahlan, S. Ompusunggu","doi":"10.21182/jmisst.2023.01025","DOIUrl":"https://doi.org/10.21182/jmisst.2023.01025","url":null,"abstract":"Our objective was to document the surgical results from a case and conduct a retrospective analysis of partial vertebrectomy in neglected spondyloptosis at the T10–11 level. Traumatic spondyloptosis is a severe and rare spinal cord injury. In spondyloptosis, there is a traumatic subluxation of adjacent vertebral bodies that exceeds the normal anatomical limits. The thoracic vertebrae possess a rigid skeleton, and the sternum also contributes to maintaining stability in the upper-middle chest area. Therefore, instances of spondyloptosis in the thoracic spine are exceedingly rare. Thoracic spondyloptosis typically results in neurological deficits. A 45-year-old man presented to the neurosurgery outpatient clinic complaining of weakness of lower extremities, back pain, headache, and vomiting. The patient was hospitalized for 7 days, and he was diagnosed with neglected spondyloptosis based on a computed tomography scan. The patient was treated using laminectomy decompression, bilateral facetectomy, partial vertebrectomy, and posterior stabilization. Management in cases of spondyloptosis has the aim of reduction, alignment, and stabilization. Early surgery with reduction and rigid stabilization is preferable to conservative treatment in most cases. The surgical approach can be anterior, posterior, or combined, without significant differences. Vertebrectomy is performed to remove part of the vertebral body to reduce spinal cord pressure. Thoracic spondyloptosis is a very rare but severe type of spinal cord injury. Neurological deficits are common in patients with this condition. Early management involving reduction and stabilization is generally recommended to obtain a better outcome.","PeriodicalId":405058,"journal":{"name":"Journal of Minimally Invasive Spine Surgery and Technique","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139600861","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":"Comparative Analysis of Uniportal and Biportal Endoscopic Transforaminal Lumbar Interbody Fusion in Early Learning Stage: Technical Considerations and Radiological Outcomes","authors":"Ji Yeon Kim, Hyun Jin Hong, H. Kim, Dong Hwa Heo, Su Yong Choi, Kyoung Mo Kim, Dong Chan Lee, Choon-Keun Park","doi":"10.21182/jmisst.2023.01032","DOIUrl":"https://doi.org/10.21182/jmisst.2023.01032","url":null,"abstract":"Objective: This study compared the clinical and radiological outcomes of uniportal endoscopic and biportal endoscopic transforaminal lumbar interbody fusion (TLIF) for lumbar degenerative disease during the early learning stage of the technique. Methods: We retrospectively analyzed patients who underwent uniportal endoscopic TLIF (n=15) and biportal endoscopic TLIF (n=19) between January and October 2021 during the first year of adoption of these techniques. Radiological parameters, including Bridewell fusion and subsidence grading, were evaluated by x-ray and computed tomography (CT) at 3-month, 6-month, and 1-year follow-up visits. Clinical outcomes were evaluated using the visual analogue scale (VAS) and the Oswestry Disability Index (ODI). Results: Uniportal endoscopic TLIF showed significantly higher frequencies of intraoperative endplate injuries (uniportal [20%] vs. biportal [0%], p=0.01) and 1-year cage subsidence (uni-portal [60%] vs. biportal [26.3%], p=0.04) than biportal endoscopic TLIF. The 1-year fusion rates did not differ significantly between the 2 surgical groups (uniportal [93.3%] vs. biportal [89.5%], p=0.37). Neural complications such as postoperative dysesthesia and dural tears oc-curred in uniportal endoscopic TLIF. There were no significant differences in the VAS for back and leg pain or ODI. Conclusion: Complete endplate preparation under endoscopic guidance improved interbody fusion, and this procedure may be feasible in the early learning stage, regardless of the type of endoscope. Both endoscopic TLIF techniques achieved good clinical outcomes and fusion rates. However, unskilled use of the cage guide device caused endplate breakage and neural injury during uniportal endoscopic cage insertion. Uniportal endoscopic TLIF may require more experience for appropriate cage insertion.","PeriodicalId":405058,"journal":{"name":"Journal of Minimally Invasive Spine Surgery and Technique","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139601365","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":"Diagnosis of Lumbar Foraminal Stenosis: A Literature Review","authors":"Eiji Abe, Y. Ohara, Takeshi Hara, Hirokazu Iwamuro, H. Nojiri, Akihide Kondo","doi":"10.21182/jmisst.2023.00969","DOIUrl":"https://doi.org/10.21182/jmisst.2023.00969","url":null,"abstract":"stenosis. Subsequently, selective nerve root injection and CT have become popular, with MRI being the main diagnostic modality. The development of sequences such as 3-dimensional MRI, oblique coronal MRI, and diffusion tensor tractography has improved the diagnostic performance of imaging examinations. Thus, a better understanding of lumbar stenotic lesions among spine surgeons, in combination with more accurate imaging examinations, is expected to improve the accuracy of diagnoses, which in turn will help enhance the quality of treatment.","PeriodicalId":405058,"journal":{"name":"Journal of Minimally Invasive Spine Surgery and Technique","volume":"111 27","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139616406","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 Paramedian Partial Lumbar Corpectomy for a Lumbar Burst Fracture With Spinal Canal and Foraminal Stenosis: A Case Report With a Technical Note","authors":"Chun-Hao Lin, Jeffrey Wu, Ting-Shuo Hsu, Yueh-Ying Hsieh, Chang-Jung Chiang, Chia-Hsien Chen","doi":"10.21182/jmisst.2023.00906","DOIUrl":"https://doi.org/10.21182/jmisst.2023.00906","url":null,"abstract":"Burst fractures are common in thoracolumbar spinal injuries, often resulting in vertebral collapse with or without neurological deficits. While traditional open surgery is the standard approach for surgical decompression, it has some drawbacks and complications. Conversely, full endoscopic spine surgery remains underexplored for these patients. This case report presents a 77-year-old patient with an L3 burst fracture and severe neurological deficits caused by retro-pulsion bone fragments, leading to spinal canal compromise and right L3–4 foraminal stenosis. The patient underwent a full endoscopic paramedian approach for partial lumbar corpectomy and foraminal fragment removal. Vertebroplasty and short-segment pedicle screw fixation were also performed to restore sagittal alignment and spinal stability. After surgery, the patient experienced significant improvements in pain, numbness, and muscle strength. Radiographic assessments confirmed successful correction of the deformity and decompression of the spinal canal. The study emphasizes the benefits of endoscopic techniques in enhancing patient recovery for burst fractures. However, certain limitations are acknowledged, including the need for further research and expertise in utilizing this approach. In conclusion, paramedian endoscopy shows promise as a valuable alternative to traditional open surgery, offering potential advantages in terms of complications and recovery for burst fracture management.","PeriodicalId":405058,"journal":{"name":"Journal of Minimally Invasive Spine Surgery and Technique","volume":"44 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139390578","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":"Endoscopic Fixation of Bilateral L5 Spondylolysis Based on a New Technique: A Case Report","authors":"Marcelo Botelho Soares de Brito, Bruno Brasil do Couto, Geison Victor Gonçalves Silveira, Victor Gabriel Izel D’Andrade, Thiago Sequeira da Cruz, João Paulo Cavalcanti Figueiredo Soares","doi":"10.21182/jmisst.2023.01060","DOIUrl":"https://doi.org/10.21182/jmisst.2023.01060","url":null,"abstract":"We describe the use of an endoscopic approach to fix a pars interarticularis defect in a 33-year-old man with a 7-year history of refractory low back pain, whose case had been previously diagnosed as spondylolysis. The advantage of using this technique lies in minimum muscle trauma, since it only requires a single 6-mm transverse incision. Neither intraoperative nor postoperative complications were observed. The patient reported nocturnal pain improvement and presented favourable clinical recovery after 3.5 years of follow-up. He recorded an 8% Oswestry Disability Index and visual analogue scale scores of 2 and 0 for low back and lower-limb pain, respectively. Therefore, the endoscopic technique described herein is a feasible approach to treating spondylolysis.","PeriodicalId":405058,"journal":{"name":"Journal of Minimally Invasive Spine Surgery and Technique","volume":"111 41","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139390843","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":"Comparative Study of the Outcomes of Endoscopic Unilateral Laminotomy for Bilateral Decompression (ULBD) With Destandau Technique and Microscopic ULBD: A Randomized Double-Blinded Study of 685 Patients","authors":"P. C. Dey, Nishit Palo, Abhishek Shukla","doi":"10.21182/jmisst.2023.00829","DOIUrl":"https://doi.org/10.21182/jmisst.2023.00829","url":null,"abstract":"Objective: Lumbar canal stenosis is a common finding amongst elderly patients visiting spine surgeons for back pain. Uniportal unilateral laminotomy for bilateral decompression (ULBD) is an emerging minimally invasive procedure for lumbar canal stenosis. This study compared the clinical outcomes of endoscopic ULBD with Destandau technique and microscopic lumbar canal decompression. Methods: A prospective multicenter study on 685 patients undergoing single-level spinal canal decompression. Patients with axial back pain, lumbar radiculopathy, lumbar canal stenosis & claudication distance <1,000 m were included. Parameters assessed were Dura expansion, thecal sac’s cross-sectional area, horizontal displacement, blood loss, operation time, hospital stay, modified MacNab score, visual analogue score (VAS), side changing (self) status, Oswestry Disability Index (ODI), and the Short-Form 36 for quality of life (QoL). Results: Group 1 (endoscopic ULBD with Destandau technique) had 343 patients and group 2 (microscopic ULBD) had 342 patients. Group 1 had lower horizontal displacement (0.34%±0.21%, p<0.001) and significant improvement of VAS (42.28%±3.20%, p<0.001) at 1-week postsurgery with shorter hospital stay (1±0.2 days vs. 1.8±0.8 days, p<0.01) and significant improvements of ODI and MacNab scores (42.28±3.20 and 85.30%, p<0.001). The 30-second chair test (3.4±0.13 vs. 5.6 ± 2.41, p<0.001), 10-meter walk test (1.0 ± 2.15 vs. 0.55 ± 3.23, p<0.001), and SF-36 physical health component score (48.20±8.46 vs. 74.48±0.54, p<0.001) improved significantly as well. Furthermore, 92% of patients were able to change sides while in bed at 1-week postsur-gery. Claudication distance improved significantly in both groups. Conclusion: Group 1 patients had better clinical and functional outcomes within 3 months of surgery than group 2 patients, with improved QoL, shorter hospital stays, claudication distance, and self-side changing ability.","PeriodicalId":405058,"journal":{"name":"Journal of Minimally Invasive Spine Surgery and Technique","volume":" 64","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138619900","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":"Overview and Prevention of Complications During Biportal Endoscopic Cervical Spine Surgery","authors":"Sang-Hyuk Park, Jung Hwan Lee, C. Chough","doi":"10.21182/jmisst.2023.00808","DOIUrl":"https://doi.org/10.21182/jmisst.2023.00808","url":null,"abstract":"Purpose: Biportal endoscopic spine surgery is becoming popular for various spinal pathologies, including cervical and thoracic spine diseases. However, the safety of biportal endoscopic cervical spine surgery (BECSS) has not been fully investigated, and inexperienced surgeons can cause serious complications. The study aimed to evaluate the complications of BECSS and identify tips for preventing them through a literature review and retrospective analysis of case series. Methods: Articles on BECSS were electronically retrieved from multiple databases, with inclusion criteria including controlled and case series designs, detailed reporting of complications and/or reoperations, and the use of BECSS. The study excluded simple review articles and case reports. The clinical data of 45 patients who underwent BECSS at our institution were collected, and information was extracted on demographic features, surgery type, surgical level, surgery-related complications, and reoperations and their reasons.Results: The study retrieved a total of 67 studies from 5 databases, of which 6 were included after screening. In total, 227 cases of BECSS were identified, and the overall complication rate was 0%–14.3%. Complications included dura tearing, symptom recurrence, incomplete decompression, postoperative epidural hematoma, and transient paralysis. Reoperation was performed in 3 cases.Conclusion: BECSS has similar complication rates to those of other surgical techniques. It is important to provide extensive education, share knowledge and experience, and conduct further research to minimize complications and improve outcomes for patients, as is the case with other spinal surgical procedures.","PeriodicalId":405058,"journal":{"name":"Journal of Minimally Invasive Spine Surgery and Technique","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125513225","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":"Outcomes of Microscopic-Assisted Decompression Surgery Without Instrumented Fixation in Patients With Spinal Canal Stenosis and First-Degree Degenerative Spondylolisthesis: A Prospective Case Series","authors":"A. Mahmoud, A. Mahmoud, H. Maniar, Sherif Ahmed El Besy, D. Horwitz","doi":"10.21182/jmisst.2023.00752","DOIUrl":"https://doi.org/10.21182/jmisst.2023.00752","url":null,"abstract":"Objective: To describe the minimally invasive, microscopic-assisted over-the-top technique and report its clinical and radiological outcomes in cases of spinal canal stenosis and first-degree degenerative lumbar spondylolisthesis.Methods: Twenty-two patients with grade I degenerative spondylolisthesis and spinal canal stenosis who underwent microscopic decompression without fusion between April 2017 and December 2020 were included in the study. Results: The study population included 13 men and 9 women, with an average age of 66.7 years (range, 55–79 years) and a mean duration of symptoms of 14.8 ± 11.6 months. The mean follow-up was 49.3 months (range, 24–67 months). At the last follow-up, 13 patients were fully satisfied, 7 patients were partially satisfied, and 2 patients (9%) were not satisfied and required revision surgery with fusion. At the final follow-up, the mean leg pain numerical pain rating scale (NPRS), back pain NPRS, Oswestry Disability Index score, and Japanese Orthopaedic Association Back Pain Evaluation Questionnaire showed significant improvements in all patients, and no patients showed progression of the degree of spondylolisthesis.Conclusion: The minimally invasive, over-the-top technique using surgical microscopy is a viable option in cases with first-degree degenerative spondylolisthesis and predominantly stenosis symptoms.","PeriodicalId":405058,"journal":{"name":"Journal of Minimally Invasive Spine Surgery and Technique","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127781358","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":"Essential Surgical Techniques During Fully Endoscopic Spine Surgery: A Historical Review and Future Perspectives","authors":"I. Choi, Y. Ahn","doi":"10.21182/jmisst.2023.00857","DOIUrl":"https://doi.org/10.21182/jmisst.2023.00857","url":null,"abstract":"Full-endoscopic spine surgery (FESS) offers minimally invasive techniques for treating spinal lesions with smaller incisions, leading to reduced tissue damage and consequently more rapid patient recovery. The essential techniques in FESS —namely, the transforaminal and interlaminar approaches—have evolved with technological advances in endoscopic systems and surgeon expertise. The transforaminal approach consists of “inside-out” and “outside-in” techniques that have distinct applications depending on the patient’s condition. The interlaminar approach, similar to traditional spinal surgery techniques, is gaining wider acceptance due to its efficacy in addressing unique anatomical challenges. Advanced procedures, such as endoscopic laminectomy and interbody fusion surgery, coupled with navigation systems, have broadened the scope of endoscopic spine surgery, making it an increasingly vital tool in modern spinal surgery.","PeriodicalId":405058,"journal":{"name":"Journal of Minimally Invasive Spine Surgery and Technique","volume":"81 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133914771","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":"Clinical and Radiologic Outcomes of Biportal Endoscopic Lumbar Interbody Fusion With a Long Polyetheretherketone Cage","authors":"C. Park, A. Anzar, Beom seok Yoo, Jae Eon Yoon, Jae Hyun Kim, W. Park","doi":"10.21182/jmisst.2023.00745","DOIUrl":"https://doi.org/10.21182/jmisst.2023.00745","url":null,"abstract":"Objective: With the latest advances and innovations in field of spine surgery, the new generation of spine surgeons has been increasingly preferring the endoscopic lumbar interbody fusion technique to treat the pathology of lumbar degenerative disease. The aim of this study was to elucidate the clinical and radiologic outcomes of biportal endoscopic lumbar interbody fusion with a long polyetheretherketone (PEEK) cage.Methods: This study included 40 patients treated by biportal endoscopic lumbar interbody fusion with a long PEEK cage between January 2020 and December 2021. The clinical evaluation was conducted using improvements in visual analogue scale (VAS) and Oswestry Disability Index (ODI) scores. Radiological outcomes were evaluated by changes in disc height and segmental and lumbar lordosis. Fusion was assessed based on computed tomography scans using the Bridewell criteria. Surgical parameters (e.g., operative duration, blood loss and complications) were noted.Results: Of the 40 patients in this study, 13 were male and 27 were female. Most patients had significant clinical improvement as indicated by improvements in VAS and ODI scores (p < 0.05). Disc height, segmental lordosis, and lumbar lordosis showed significant improvements (p < 0.05). The mean surgical duration was 180 minutes, and the mean blood loss was 80 mL. All patients had grade 1 or 2 fusion.Conclusion: Biportal endoscopic fusion using a long PEEK cage is an excellent option for achieving good interbody fusion when indicated. A long-term follow-up study would be needed to fully clarify the effectiveness of this procedure.","PeriodicalId":405058,"journal":{"name":"Journal of Minimally Invasive Spine Surgery and Technique","volume":"549 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123424413","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}