Recognition and management of problems inherent in spinal stenosis require a clear understanding of the diverse anatomic changes, their radiologic representations, and careful correlation with a wide spectrum of fluctuating clinical manifestations. Although a common basis might be postulated for narrowing of the spinal canal, emphasis should be placed on its various forms.
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Neurospine
December 2024
Department of Orthopedic Surgery, Spine Center, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Objective: To compare the safety profiles of biportal endoscopic spinal surgery (BESS) and microscopic spinal surgery (MSS) for lumbar disc herniation and spinal stenosis by analyzing the associated adverse events.
Methods: We pooled data from 2 prospective randomized controlled trials involving 220 patients (110 in each group) who underwent single-level lumbar surgery. Participants aged 20-80 years with radiating pain due to lumbar disc herniation or spinal stenosis were included in this study.
Neurospine
December 2024
Department of Neurosurgery, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Objective: Spinal stenosis is a prevalent condition; however, the optimal surgical treatment for central lumbar stenosis remains controversial. This study compared the clinical outcomes and radiological parameters of 3 surgical.
Methods: unilateral laminectomy bilateral decompression with unilateral biportal endoscopy (ULBD-UBE), conventional subtotal laminectomy (STL), and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF).
Neurospine
December 2024
Balgrist University Hospital, Zurich, Switzerland.
This video aims to describe an endoscopic surgical approach for accessing difficult to reach pathology such as disc herniations after previous surgery. The relatively small size of endoscopic instruments facilitates significant freedom of movement inside the spinal canal. The authors have experience with interlaminar approaches for contralateral pathology such as disc herniations, recurrent disc herniations, spinal stenosis, and facet cysts.
View Article and Find Full Text PDFNeurospine
December 2024
Department of Orthopedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
This video presents a case of L4-5 unstable spondylolisthesis treated with full-endoscopic transforaminal lumbar interbody fusion (Endo-TLIF), emphasizing the GUARD (Glider Used as a Rotary Device) technique for nerve root protection. This innovative approach involves controlled rotation of the cage glider before cage insertion to minimize the risk of nerve root injury, a significant complication in Endo-TLIF procedures. The GUARD technique, validated in previous cadaveric studies, provides enhanced safety during cage insertion by protecting the nerve root.
View Article and Find Full Text PDFNeurospine
December 2024
Morgenstern Institute of Spine, Centro Médico Teknon, Barcelona, Spain.
This article aims to introduce a novel full-endoscopic anterior cervical discectomy and fusion (ACDF) procedure to treat cervical myelopathy. Adoption of endoscopic anterior cervical procedures has been lagging due to safety concerns and the necessity of placing an interbody cage. We have developed novel instrumentation and a modified percutaneous anterior cervical approach that allows a safe and reproducible full-endoscopic ACDF.
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