Spine J
Spine Health Wooridul Hospital (Gangnam), 445, Hakdong-ro, Gangnam-gu, Seoul 135-951, Republic of Korea. Electronic address:
Published: July 2018
Background Context: L5-S1 transforaminal percutaneous endoscopic lumbar discectomy (PELD) is a demanding procedure because of structures such as iliac crest, L5 transverse process, hypertrophic L5-S1 facet joint, and sacral ala. There has been no definite preoperative evaluation method to evaluate the surgical validity of L5-S1 transforaminal PELD.
Purpose: The authors report a new preoperative trajectory evaluation method for L5-S1 transforaminal PELD using magnetic resonance imaging (MRI) or computed tomography (CT) examinations.
Study Design/setting: This is a technical report study.
Patient Sample: Patients who were diagnosed L5-S1 soft disc herniation were included in the present study.
Outcome Measures: Success rate of transforaminal PELD according to height of iliac crest was measured.
Methods: Twelve patients who were diagnosed L5-S1 disc herniation were preoperatively evaluated with this new method. A skin marker is attached to patient's back as a tentative skin entry point, which was determined by usual preoperative MRI or CT. A new tilted axial and coronal MRI or CT scan is performed according to axis of L5-S1 transforaminal working channel. The images show good relationship between working channel and iliac crest.
Results: Six patients underwent a transforaminal PELD, and the results were successful. The other six patients were considered to be "unsuitable" for transforaminal PELD because of the probable blockade by iliac crest.
Conclusions: The tilted MRI or CT provides precise evaluation for L5-S1 transforaminal PELD trajectory and may achieve good outcome.
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http://dx.doi.org/10.1016/j.spinee.2018.02.021 | DOI Listing |
Medicine (Baltimore)
January 2025
Ningbo Medical Center LiHuiLi Hospital, Ningbo, Zhejiang, PR China.
Rationale: Alkaptonuria (AKU) is a rare, inherited metabolic disease caused by deficient activity of homogentisic acid oxidase, leading to the accumulation of homogentisic acid and its oxidized product, benzoquinone acetic acid. These compounds cause black discoloration of cartilage, degeneration, inflammation, and calcification of intervertebral disks and large joints, resulting in pain and impaired quality of life. Despite its debilitating effects, there are no curative treatments for AKU, and management remains supportive.
View Article and Find Full Text PDFInt J Spine Surg
January 2025
Department of Orthopedic Surgery, University of Virginia, Charlottesville, VA, USA
Background: A limited number of studies have compared the outcomes of anterior lumbar interbody fusion (ALIF) to transforaminal lumbar interbody fusion (TLIF) for the treatment of isthmic spondylolisthesis. This study aims to compare postoperative complications between these two surgical approaches.
Methods: A retrospective review was performed using a large national database.
J Clin Neurosci
January 2025
Division of Neurosurgery, Department of Surgery, Brawijaya University/Saiful Anwar General Hospital, Malang, East Java, Indonesia.
Background: Percutaneous Endoscopic Lumbar Discectomy (PELD) is a leading minimally invasive technique for lumbar disc herniation (LDH). The two primary approaches, transforaminal (PETD) and interlaminar (PEID), each present distinct advantages and challenges in treating L5-S1 LDH. This study aims to compare the efficacy and safety of these two approaches.
View Article and Find Full Text PDFJ Orthop Sci
January 2025
Department of Orthopedic Surgery, Faculty of Medicine and Graduate of Medicine, Hokkaido University, N15W7, Sapporo, Hokkaido, 065-0024, Japan.
Background: Pseudarthrosis is a major complication after posterior lumbar interbody fusion (PLIF) and transforaminal interbody fusion (TLIF), and its risk factors need to be identified. This study aimed to investigate the relationship between the number of remaining teeth (NRT) and pseudarthrosis.
Methods: NRT, preoperative bone density of the proximal femur (percentages of young adult mean; % YAM), and preoperative procollagen type 1 N-terminal propeptide (P1NP) (μg/L) were retrospectively investigated in 63 patients (24 male and 39 female, mean age: 71.
Neurospine
December 2024
Department of Neurosurgery, Chosun University Hospital, Gwangju, Korea.
This case report and video demonstrate the technique of full-endoscopic J-shaped transforaminal L5 exiting nerve decompression in Bertolotti syndrome. Bertolotti syndrome, characterized by a congenital lumbosacral transitional vertebra, often results in mechanical lower back pain and nerve root compression. A 69-year-old male presented with progressive radiating pain in the right leg and tingling in the L5 dermatome.
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