Aim of this study was to analyze variation in angulation of trajectories of various skin entry points in transforaminal endoscopic spine surgery with change in the physical parameters, namely, weight, abdominal girth, and body mass index and to validate our hypothesis that posterolateral (PL)-tip of spinous process (TOSP) entry has minimal variation in the angle of trajectory as compared with currently available skin entry points. The study included an analysis of the functional outcomes of these patients who underwent transforaminal endoscopy using the novel PL-TOSP technique, assessing improvements in pain and disability. Entry point in transforaminal endoscopic lumbar discectomy (TELD) was taken as a rough distance of 10 to 12 cm from midline as proposed by Kambin whereas Yeung and Tsou advised entry point as distance between the center of the disc space and the posterior skin line measured on lateral.
View Article and Find Full Text PDFIntroduction: Low back pain persisting after spine surgery presents diagnostic and treatment complexities for spine surgeons. Failed back syndrome is a term usually used to characterize chronic back or leg pain following spine surgery. Research has indicated a range of persistent pain occurrences after spine surgery.
View Article and Find Full Text PDFBackground: Lumbar discal pseudocysts are uncommon complications that can arise following lumbar spine surgery. It manifests as a fluid-filled sac near the intervertebral disc, causing pain and discomfort. Understanding its causes, symptoms, and management is crucial for patients and healthcare professionals involved in postoperative spinal care.
View Article and Find Full Text PDFBackground Context: Both Transforaminal (TF) and Interlaminar (IL) endoscopic approaches are established techniques of decompression for lumbar compressive radiculopathy. In the absence of adequate literature, there is always some dilemma in selecting the approach for endoscopic decompression leading to long learning curves and high chances of inadequate decompression, iatrogenic instability, dural tear, or dysesthesia. Hence authors propose a new surgical nomenclature and algorithm for selection of endoscopic approach.
View Article and Find Full Text PDFProspective evaluation of the effect of physical parameters like height, weight and abdominal girth on different skin entry points in transforaminal endoscopic lumbar discectomy (TELD) in lower lumbar discs. This prospective study involved 174 patients with unilateral radicular pain or discogenic back pain, central, paracentral disc herniations and lateral canal stenosis at the level from L3 to S1 radiologically confirmed by magnetic resonance imaging (MRI) and failed conservative trial for 6 weeks. All patients underwent measurements of height, weight, body mass index (BMI), and abdominal girth preoperatively.
View Article and Find Full Text PDFBackground: A definitive diagnosis of spinal tuberculosis (TB) remains challenging. The "gold standard" is to obtain histopathological confirmation of the lesion. This analysis highlights how to avoid missing the diagnosis of an extramedullary myeloid sarcoma (EMS) versus TB.
View Article and Find Full Text PDFIntroduction: Lumbar disc herniation (LDH) is common manifestation of a degenerative disease involving tensile failure of the annulus to contain the gel like nuclear portion of the disc. Lumbar herniated discs can often cause muscle weakness, reduced motor function, and change in walking capacity and gait pattern.
Case Presentation: We present the case of an 18-year-old obese hypertensive male, with multiple level lumbar disc herniation, with a neurological deficit and failed conservative treatment.
J Clin Orthop Trauma
January 2020
Rosai Dorfman disease (RDD) also known as sinus histiocytosis with massive lymphadenopathy (SHML) is a rare non-malignant proliferative disorder of unknown etiology. Here we present a case of Rosai Dorfman disease of the spine causing lumbo-sacral radiculopathy. CT and MRI revealed lytic expansile lesion in the left half of L4 vertebra mainly involving posterior aspect involving left pedicle and transverse process.
View Article and Find Full Text PDFBackground: Approach to the L5-S1 level with transforaminal access can be challenging. Some surgeons employ the interlaminar or paraspinal endoscopic approach as an alternative apart from the other minimally invasive posterior surgical options. To precisely target and safely access disc herniations at L5-S1, the authors attempted to stratify patients into trans and supra iliac approach groups and propose a simple surgical classification based on the radiographic findings.
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