Advertisement

Endoscopic Effort to Overcome Anatomical Barriers

  • Javier Quillo-Olvera
  • Jin-Sung Kim
Chapter

Abstract

Endoscopic surgery is a minimally invasive and feasible option for the treatment of lumbar disc herniations. The technological advances applied to the new endoscopic instruments help to overcome the anatomical barriers that make this procedure difficult in complex anatomical situations. Currently, some techniques allow us to reach disc fragments distal to the intervertebral space. In this chapter, several options to overcome the anatomical barriers with endoscopic procedures are presented.

Keywords

Endoscopic posterolateral approach Iliac wing Migrated disc herniation Endoscopic transpedicular approach Endoscopic foraminoplasty Minimally invasive spine surgery 

Abbreviations

AP

Anteroposterior

DRG

Dorsal root ganglion

MRI

Magnetic resonance imaging

ODI

Oswestry disability index

PELD

Percutaneous endoscopic lumbar discectomy

PELDA

Percutaneous endoscopic lumbar discectomy

PEN

Percutaneous epidural neuroplasty

PETA

Percutaneous endoscopic translaminar approach

PSIS

Posterior-superior iliac spine

SAP

Superior articular process

VAS

Visual analog pain scale

References

  1. 1.
    Kambin P, Sampson S. Posterolateral percutaneous suction-excision of herniated lumbar intervertebral discs. Report of interim results. Clin Orthop Relat Res. 1986;207:37–43.Google Scholar
  2. 2.
    Choi KC, Kim JS, Ryu KS, Kang BU, Ahn Y, Lee SH. Percutaneous endoscopic lumbar discectomy for L5-S1 disc herniation: transforaminal versus interlaminar approach. Pain Physician. 2013;16:547–56.Google Scholar
  3. 3.
    Choi KC, Kim JS, Park CK. Percutaneous endoscopic lumbar discectomy as an alternative to open lumbar microdiscectomy for large lumbar disc herniation. Pain Physician. 2016;19:E291–300.PubMedGoogle Scholar
  4. 4.
    Ruetten S, Komp M, Merk H, Godolias G. Full-endoscopic interlaminar and transforaminal lumbar discectomy versus conventional microsurgical technique: a prospective, randomized, controlled study. Spine (Phila Pa 1976). 2008;33:931–9.  https://doi.org/10.1097/BRS.0b013e31816c8af7.CrossRefGoogle Scholar
  5. 5.
    Choi KC, Lee DC, Shim HK, Shin SH, Park CK. A strategy of percutaneous endoscopic lumbar discectomy for migrated disc herniation. World Neurosurg. 2017;99:259–66.  https://doi.org/10.1016/j.wneu.2016.12.052.CrossRefPubMedGoogle Scholar
  6. 6.
    Choi KC, Park CK. Percutaneous endoscopic lumbar discectomy for L5-S1 disc herniation: consideration of the relation between the iliac crest and L5-S1 disc. Pain Physician. 2016;19:E301–8.PubMedGoogle Scholar
  7. 7.
    Osman SG, Marsolais EB. Endoscopic transiliac approach to L5-S1 disc and foramen. A cadaver study. Spine (Phila Pa 1976). 1997;22:1259–63.CrossRefGoogle Scholar
  8. 8.
    Choi G, Kim JS, Lokhande P, Lee SH. Percutaneous endoscopic lumbar discectomy by transiliac approach: a case report. Spine (Phila Pa 1976). 2009;34:E443–6.  https://doi.org/10.1097/BRS.0b013e31817c4f39.CrossRefGoogle Scholar
  9. 9.
    Lu J, Ebraheim NA, Huntoon M, Heck BE, Yeasting RA. Anatomic considerations of superior cluneal nerve at posterior iliac crest region. Clin Orthop Relat Res. 1998;347:224–8.CrossRefGoogle Scholar
  10. 10.
    Mayer HM, Brock M. Percutaneous endoscopic discectomy: surgical technique and preliminary results compared to microsurgical discectomy. J Neurosurg. 1993;78:216–25.CrossRefGoogle Scholar
  11. 11.
    Yeom KS, Choi YS. Full endoscopic contralateral transforaminal discectomy for distally migrated lumbar disc herniation. J Orthop Sci. 2011;16:263–9.  https://doi.org/10.1007/s00776-011-0048-0.CrossRefPubMedGoogle Scholar
  12. 12.
    Choi G, Lee SH, Lokhande P, Kong BJ, Shim CS, Jung B, et al. Percutaneous endoscopic approach for highly migrated intracanal disc herniations by foraminoplastic technique using rigid working channel endoscope. Spine (Phila Pa 1976). 2008;33:E508–15.  https://doi.org/10.1097/BRS.0b013e31817bfa1a.CrossRefGoogle Scholar
  13. 13.
    Kim JS, Choi G, Lee SH. Percutaneous endoscopic lumbar discectomy via contralateral approach: a technical case report. Spine (Phila Pa 1976). 2011;36:E1173–8.  https://doi.org/10.1097/BRS.0b013e3182264458.CrossRefGoogle Scholar
  14. 14.
    Liu C, Chu L, Yong HC, Chen L, Deng ZL. Percutaneous endoscopic lumbar discectomy for highly migrated lumbar disc herniation. Pain Physician. 2017;20:E75–84.PubMedGoogle Scholar
  15. 15.
    Krzok G, Telfeian AE, Wagner R, Iprenburg M. Transpedicular lumbar endoscopic surgery for highly migrated disk extrusions: preliminary series and surgical technique. World Neurosurg. 2016;95:299–303.  https://doi.org/10.1016/j.wneu.2016.08.018.CrossRefPubMedGoogle Scholar
  16. 16.
    Torun F, Tuna H, Buyukmumcu M, Caglar S, Baysefer A. The lumbar roots and pedicles: a morphometric analysis and anatomical features. J Clin Neurosci. 2008;15:895–9.  https://doi.org/10.1016/j.jocn.2007.08.006.CrossRefPubMedGoogle Scholar
  17. 17.
    Uniyal P, Choi G, Khedkkar B. Percutaneous transpedicular lumbar endoscopy: a case report. Int J Spine Surg. 2016;10:31.CrossRefGoogle Scholar
  18. 18.
    Knight MT, Vajda A, Jakab GV, Awan S. Endoscopic laser foraminoplasty on the lumbar spine – early experience. Minim Invasive Neurosurg. 1998;41:5–9.CrossRefGoogle Scholar
  19. 19.
    Choi I, Ahn JO, So WS, Lee SJ, Choi IJ, Kim H. Exiting root injury in transforaminal endoscopic discectomy: preoperative image considerations for safety. Eur Spine J. 2013;22:2481–7.  https://doi.org/10.1007/s00586-013-2849-7.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Hurday Y, Xu B, Guo L, Cao Y, Wan Y, Jiang H, et al. Radiographic measurement for transforaminal percutaneous endoscopic approach (PELD). Eur Spine J. 2017;26:635–45.  https://doi.org/10.1007/s00586-016-4454-z.CrossRefPubMedGoogle Scholar
  21. 21.
    Henmi T, Terai T, Nagamachi A, Sairyo K. Morphometric changes of the lumbar intervertebral foramen after percutaneous endoscopic foraminoplasty under local anesthesia. J Neurol Surg A Cent Eur Neurosurg. 2017;  https://doi.org/10.1055/s-0037-1599059.CrossRefGoogle Scholar
  22. 22.
    Lee SH, Kang HS, Choi G, Kong BJ, Ahn Y, Kim JS, et al. Foraminoplastic ventral epidural approach for removal of extruded herniated fragment at the L5-S1 level. Neurol Med Chir (Tokyo). 2010;50:1074–8.CrossRefGoogle Scholar
  23. 23.
    Schubert M, Hoogland T. Endoscopic transforaminal nucleotomy with foraminoplasty for lumbar disk herniation. Oper Orthop Traumatol. 2005;17:641–61.CrossRefGoogle Scholar
  24. 24.
    Choi KC, Shim HK, Park CJ, Lee DC, Park CK. Usefulness of percutaneous endoscopic lumbar foraminoplasty for lumbar disc herniation. World Neurosurg. 2017;106:484–92.  https://doi.org/10.1016/j.wneu.2017.07.035.CrossRefPubMedGoogle Scholar
  25. 25.
    Ruetten S, Komp M, Merk H, Godolias G. Use of newly developed instruments and endoscopes: full-endoscopic resection of lumbar disc herniations via the interlaminar and lateral transforaminal approach. J Neurosurg Spine. 2007;6:521–30.CrossRefGoogle Scholar
  26. 26.
    Cohen MS, Wall EJ, Brown RA, Rydevik B, Garfin SR. 1990 AcroMed award in basic science. Cauda equina anatomy. II: Extrathecal nerve roots and dorsal root ganglia. Spine (Phila Pa 1976). 1990;15:1248–51.CrossRefGoogle Scholar
  27. 27.
    Di Lorenzo N, Porta F, Onnis G, Cannas A, Arbau G, Maleci A. Pars interarticularis fenestration in the treatment of foraminal lumbar disc herniation: a further surgical approach. Neurosurgery. 1998;42:87–9.CrossRefGoogle Scholar
  28. 28.
    Dezawa A, Mikami H, Sairyo K. Percutaneous endoscopic translaminar approach for herniated nucleus pulposus in the hidden zone of the lumbar spine. Asian J Endosc Surg. 2012;5:200–3.  https://doi.org/10.1111/j.1758-5910.2012.00142.x.CrossRefPubMedGoogle Scholar
  29. 29.
    Du J, Tang X, Jing X, Li N, Wang Y, Zhang X. Outcomes of percutaneous endoscopic lumbar discectomy via a translaminar approach, especially for soft, highly down-migrated lumbar disc herniation. Int Orthop. 2016;40:1247–52.  https://doi.org/10.1007/s00264-016-3177-4.CrossRefPubMedGoogle Scholar
  30. 30.
    Parker SL, Xu R, McGirt MJ, Witham TF, Long DM, Bydon A. Long-term back pain after a single-level discectomy for radiculopathy: incidence and health care cost analysis. J Neurosurg Spine. 2010;12:178–82.  https://doi.org/10.3171/2009.9.SPINE09410.CrossRefPubMedGoogle Scholar
  31. 31.
    Hanley EN Jr, Shapiro DE. The development of low-back pain after excision of a lumbar disc. J Bone Joint Surg Am. 1989;71:719–21.CrossRefGoogle Scholar
  32. 32.
    Rauschning W. Pathoanatomy of lumbar disc degeneration and stenosis. Acta Orthop Scand Suppl. 1993;251:3–12.CrossRefGoogle Scholar
  33. 33.
    Ohtori S, Yamashita M, Yamauchi K, Inoue G, Koshi T, Suzuki M, et al. Low back pain after lumbar discectomy in patients showing endplate Modic type 1 change. Spine (Phila Pa 1976). 2010;35:E596–600.  https://doi.org/10.1097/BRS.0b013e3181cd2cb8.CrossRefGoogle Scholar
  34. 34.
    Choi KC, Kim JS, Kang BU, Lee CD, Lee SH. Changes in back pain after percutaneous endoscopic lumbar discectomy and annuloplasty for lumbar disc herniation: a prospective study. Pain Med. 2011;12:1615–21.  https://doi.org/10.1111/j.1526-4637.2011.01250.x.CrossRefPubMedGoogle Scholar
  35. 35.
    Lee JH, Lee SH. Clinical efficacy and its prognostic factor of percutaneous endoscopic lumbar annuloplasty and nucleoplasty for the treatment of patients with discogenic low back pain. World Neurosurg. 2017;105:832–40.  https://doi.org/10.1016/j.wneu.2017.06.112.CrossRefPubMedGoogle Scholar
  36. 36.
    Lee HJ, Kim JS, Ryu KS. Transforaminal percutaneous endoscopic lumbar diskectomy with percutaneous epidural neuroplasty in lumbar disk herniation: technical note. World Neurosurg. 2017;98:876.e23–31.  https://doi.org/10.1016/j.wneu.2016.11.078.CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2020

Authors and Affiliations

  • Javier Quillo-Olvera
    • 1
  • Jin-Sung Kim
    • 1
  1. 1.Spine Center, Department of Neurosurgery, Seoul St. Mary’s Hospital, College of MedicineThe Catholic University of KoreaSeoulSouth Korea

Personalised recommendations