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Biportal endoscopic spine surgery for cervical disk herniation: A technical notes and preliminary report.

ABSTRACT: Biportal endoscopic spine surgery (BESS) for cervical disk herniation (CDH) has been rarely reported. The aim of the article is to describe a novel BESS as a posterior approach for CDH and report the preliminary outcomes and complications. This single-centered retrospective chart review included 109 consecutive patients who underwent BESS for symptomatic single-level CDH. Working and viewing portals were created in each unilateral paravertebral area at the target disk level. Endoscopic exploration allowed for effective and minimally invasive decompression via safe access to the medial foramen with minimal laminectomy and facetectomy. Clinical outcomes, including the visual analog scale, neck disability index, Macnab criteria, and the motor function of the involved arm, were evaluated at 4, 8, 12, and 24 postoperative weeks. Visual analog scale and neck disability index improved significantly at 24 weeks postoperatively (P < .01). According to the Macnab criteria, "excellent," "good," and "fair" results were obtained for 55.9%, 30.3%, and 13.8% of patients, respectively. The post 24-week distribution of the involved upper extremity strength grade was significantly improved compared to the initial value (P = .02). One patient had a motor weakness with a decreased grade over 4 weeks from excessive irrigation. The posterior approach of BESS was efficient and feasible for the treatment of CDH.

SUBMITTER: Jung SB

PROVIDER: S-EPMC9259155 | biostudies-literature |

REPOSITORIES: biostudies-literature

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The Biportal Endoscopic Posterior Cervical Inclinatory Foraminotomy for Cervical Radiculopathy: Technical Report and Preliminary Results.

Project description:The purpose of the current study was to introduce a surgical technique for posterior cervical inclinatory foraminotomy (PCIF) using a percutaneous biportal endoscopic (BE) approach. Consecutive 7 patients underwent BE-PCIF for their cervical radiculopathy. Postoperative radiologic images (x-rays, computed tomography [CT], and magnetic resonance imaging [MRI]) were evaluated postoperatively for optimal neural decompression status and stability. A visual analogue scale (VAS) for the arm pain and the Neck Disability Index were used to evaluate clinical results in the preoperative and postoperative periods. Mean follow-up periods were 6.42 ± 2.99 months. The mean operative time was 101.42 ± 49.30 minutes. Postoperative MRI and CT revealed complete removal of herniated discs and ideal neural decompression of the treated segments in all patients. Disc height and stability were preserved on postoperative x-rays. Preoperative VAS and Oswestry Disability Index scores improved significantly after the surgery. BE-PCIF may be an effective surgical treatment of the cervical radiculopathic lesions, which provides successful surgical decompression as far as distal part of foramen with better operative view and more easy surgical manipulation. This approach may also minimize iatrogenic damages of the posterior cervical musculo-ligamentous structures and help to maximize the preservation of the facet joint.

| S-EPMC7410371 | biostudies-literature

Unilateral Biportal Endoscopic Laminectomy for Treating Cervical Stenosis: A Technical Note and Preliminary Results.

Project description:Objective: The objective of this study was to introduce a surgical technique for the percutaneous decompression of cervical stenosis (CS) using a unilateral biportal endoscopic approach and characterize its early clinical and radiographic results. Materials and Methods: Nineteen consecutive patients with CS who needed surgical intervention were recruited. All enrolled patients underwent unilateral biportal endoscopic laminectomy (UBEL). All patients were followed postoperatively for >1 year. The preoperative and final follow-up evaluations included the Japanese Orthopedic Association (JOA) score for neurological assessment, visual analogue scale (VAS) for axial pain and C2-C7 Cobb angle for cervical sagittal alignment. The postoperative complications were analyzed. Results: Thirteen males and six females were included in the analysis. The mean follow-up period was 16.3 ± 2.6 months. The mean operative time was 82.6 ± 18.4 min. Postoperative MRI and CT revealed ideal neural decompression of the treated segments in all patients. Preoperative VAS and JOA scores improved significantly after the surgery, and cervical lordosis was preserved on the postoperative images. Conclusions: UBEL was an effective surgical method for CS, which may also minimize iatrogenic damage to the posterior tension band (PTB) and help to maximize the preservation of the cervical lordosis.

| S-EPMC9965142 | biostudies-literature

Hypovitaminosis D and Cervical Disk Herniation among Adults Undergoing Spine Surgery.

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| S-EPMC3854581 | biostudies-other

Pseudomeningocele after biportal endoscopic spine surgery: A case report.

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| S-EPMC7068011 | biostudies-literature

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| S-EPMC6791497 | biostudies-literature

Contralateral Keyhole Biportal Endoscopic Surgery for Ruptured Lumbar Herniated Disc: A Technical Feasibility and Early Clinical Outcomes.

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| S-EPMC7410376 | biostudies-literature

Endoscopic Treatment of Extraforaminal Entrapment of L5 Nerve Root (Far Out Syndrome) by Unilateral Biportal Endoscopic Approach: Technical Report and Preliminary Clinical Results.

Project description:ObjectiveFar out syndrome is compression and entrapment of the L5 nerve root in the extraforaminal area between the hypertrophied L5 transverse process and the sacral ala. The purpose of this study was to describe the technique of unilateral biportal endoscopic decompression for far out syndrome and to analyze early clinical results after endoscopic decompression.MethodsThe authors consecutively performed operative treatments for 16 patients with unilateral extraforaminal entrapment of the L5 nerve root (far out syndrome) using percutaneous biportal endoscopies. We included only patients who were followed more than six months after surgery. Demographic characteristics, operative time, concomitant herniated disc, and surgical complications were investigated. Clinical outcomes were evaluated using modified MacNab criteria, the visual analogue scale (VAS) for legs, and the Oswestry Disability Index (ODI).ResultsAmong 16 patients, a total of 14 cases with 4 males and 10 females were included in the study. The mean leg VAS and the ODI were significantly improved after unilateral biportal endoscopic surgery. Concomitant extraforaminal disc herniation was associated with a favorable outcome (p<0.05). Abdominal pain in the immediate postoperative period occurred in 2 patients. Abdominal pain was completely resolved with conservative management in both patients.ConclusionWe were able to achieve successful decompression of unilateral extraforaminal entrapment of the L5 nerve root using unilateral biportal endoscopic surgery. A unilateral biportal endoscopic approach may be considered as an alternative surgical treatment for far out syndrome.

| S-EPMC6449829 | biostudies-literature

Anterior cervical discectomy without fusion for a symptomatic cervical disk herniation.

Project description:BackgroundCervical radiculopathy is characterized by dysfunction of the nerve root usually caused by a cervical disk herniation. The most important symptom is pain, radiating from the neck to the arm. When conservative treatment fails, surgical treatment is indicated to relieve symptoms. During the last decades, multiple fusion techniques have been developed, although without clinical evidence for added value of fusion over non-fusion.MethodsThe surgical procedure of anterior cervical discectomy without fusion is performed step by step, leading to removal of the entire intervertebral disk.ConclusionAnterior cervical discectomy without fusion is a safe and effective treatment for cervical disk herniation.

| S-EPMC5486609 | biostudies-literature

How I do it: percutaneous transforaminal endoscopic discectomy for lumbar disk herniation.

Project description:BackgroundPercutaneous transforaminal endoscopic discectomy (PTED) has emerged as a less invasive technique to treat symptomatic lumbar disk herniation (LDH). PTED is performed under local anesthesia with the advantage of immediate intraoperative feedback of the patient. In this paper, the technique is described as conducted in our hospital.MethodsPTED is performed under local anesthesia in prone position on thoracopelvic supports. The procedure is explained stepwise: e.g. marking, incision, introduction of the 18-gauge needle and guidewire to the superior articular process, introduction of the TomShidi needle and foraminotomy up to 9 mm, with subsequently removal of disk material through the endoscope. Scar size is around 8 mm.ConclusionPTED seems a promising alternative to conventional discectomy in patients with LDH and can be performed safely.

| S-EPMC6267719 | biostudies-literature

Percutaneous Nucleoplasty for the Treatment of a Contained Cervical Disk Herniation.

Project description:Cervical radiculopathy is characterized by compression of the roots of the nerve. When conservative treatment fails and symptoms persist or increase in severity, surgical treatment is considered. Anterior cervical discectomy with or without fusion is regarded as the standard treatment for cervical disk herniation. Recently, there is an evolving trend in spinal surgery towards less invasive techniques. Nucleoplasty is a minimally invasive technique in which radiofrequency technology is used for percutaneous decompression. During the last years nucleoplasty has been proven to be a safe and effective treatment to alleviate radiculopathy, caused by a contained disk herniation. Nucleoplasty is usually performed on an outpatient basis and is associated with a fast recovery time. This paper will describe the preoperative and postoperative management of cervical nucleoplasty as well as the surgical technique, accompanied by a video.

| S-EPMC5657467 | biostudies-literature

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