Endoscopic Lumbar Micro-Decompressive Discectomy
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Endoscopic Lumbar Micro-Decompressive Discectomy Microdecompressive discectomy is performed via a combination of x-ray and endoscopic guidance An array of instruments are available to facilitate spinal neural decompression using endoscopic discectomy Endoscopic discectomy is effective in treating patients with radiculopathy due to HNP
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Endoscopic Lumbar Micro-Decompressive Discectomy
- 1. Endoscopic Lumbar Micro-Decompressive Discectomy George Rappard, Ali Maziad, MajlisAasa, James Thacker and John Chiu Presented at the American Society of Spine Radiology Annual Meeting Las Vegas, NV. February 19, 2010
- 2. Materials and Methods Retrospective single institution case series 13 consecutive patients underwent endoscopic lumbar disectomy VAS scores were collected for back and leg pain 11 patients had 1st post-op visit VAS scores 8 patients had at least 2 week follow up VAS scores available www.labrainandspine.com 1-866-4-the-bsi
- 3. Patient Inclusion Criteria Back or leg pain due to lumbar disc herniation Positive discogram Failure of conservative management Post-operative VAS data available Successful completion of lumbar endoscopic discectomy 1-866-4-the-bsi www.labrainandspine.com
- 4. Surgical Technique All procedures performed under conscious sedation Patient placed in lateral decubitus position Transforaminal and/or transpinal approach utilized Fluroscopic and endoscopic guidance Mechanical disc decompression performed Laser thermodiscoplasty performed 1-866-4-the-bsi www.labrainandspine.com
- 5. The patient is placed in the lateral decubitus position 1-866-4-the-bsi www.labrainandspine.com
- 6. The skin is marked and trajectory determined 1-866-4-the-bsi www.labrainandspine.com
- 7. Fluoroscopy is used to determine trajectory 1-866-4-the-bsi www.labrainandspine.com
- 8. The tissues along the surgical trajectory are anesthetized 1-866-4-the-bsi www.labrainandspine.com
- 9. After K-wire placement a dermotomy is performed 1-866-4-the-bsi www.labrainandspine.com
- 10. A series of dilators are advanced over the wire, transforaminaly 1-866-4-the-bsi www.labrainandspine.com
- 11. Cannula is advanced over dilator to annulus 1-866-4-the-bsi www.labrainandspine.com
- 12. Trephine is advanced through cannula, to perform annulotomy 1-866-4-the-bsi www.labrainandspine.com
- 13. Articulating forceps are used for discectomy 1-866-4-the-bsi www.labrainandspine.com
- 14. Articulating forceps are used for posterolateral discectomy 1-866-4-the-bsi www.labrainandspine.com
- 15. Articulating forceps are used for posterolateral discectomy 1-866-4-the-bsi www.labrainandspine.com
- 16. Articulating forceps are used for posterolateral discectomy 1-866-4-the-bsi www.labrainandspine.com
- 17. Endoscope is advanced transforaminaly through cannula into canal or into disc *Courtesy Maxmore spine 1-866-4-the-bsi www.labrainandspine.com
- 18. Endoscopic discectomy with cutting and grasping forceps 1-866-4-the-bsi www.labrainandspine.com
- 19. Endoscopic discectomy with cutting and grasping forceps 1-866-4-the-bsi www.labrainandspine.com
- 20. Endoscopic discectomy with cutting and grasping forceps 1-866-4-the-bsi www.labrainandspine.com
- 21. Endoscopic discectomy with cutting and grasping forceps 1-866-4-the-bsi www.labrainandspine.com
- 22. Intra-cannalicularextradiscal view of herniation *Courtesy Maxmore spine 1-866-4-the-bsi www.labrainandspine.com
- 23. Intra-cannalicularextradiscal view showing decompressed traversing nerve root *Courtesy Maxmore spine 1-866-4-the-bsi www.labrainandspine.com
- 24. Removed osteophytic and disc tissue 1-866-4-the-bsi www.labrainandspine.com
- 25. After mechanical discectomy laser cannula is advanced into disc 1-866-4-the-bsi www.labrainandspine.com
- 26. After laser thermodiscoplastydiscotome removes debris 1-866-4-the-bsi www.labrainandspine.com
- 27. Array of endoscopic discectomy devices Duckbill retractor, dilator and cannula Curettes Graspers Drills Cutting forceps Trephines Discotomes 1-866-4-the-bsi www.labrainandspine.com
- 28. Holmium YAG Laser 2100 nm wavelength 0.5mm ablation zone and 0.5mm coagulation zone Discoplasty: 40W, 1000J 1-866-4-the-bsi www.labrainandspine.com
- 31. Pre-op: 8.5
- 32. Post-op: 4
- 33. FU: 4
- 34. VAS Leg
- 35. Pre-op: 6
- 36. Post-op: 1.3
- 37. FU: 0
- 38. Average FU: 75 days1-866-4-the-bsi www.labrainandspine.com
- 39. Summary Microdecompressive discectomy is performed via a combination of x-ray and endoscopic guidance An array of instruments are available to facilitate spinal neural decompression using endoscopic discectomy Endoscopic discectomy is effective in treating patients with radiculopathy due to HNP 1-866-4-the-bsi www.labrainandspine.com
- 40. Thank You
Editor's Notes
- “decompressive” is extended on to green side bar. 3D effect on logo not utilized. Logo is wider than SNIS Superion talk. “presented at” does not appear. ASSR reference should be below the logo.
- Footer (phone number and website address) not properly justified/aligned on page. Please check on all slides.
- Remove border affects from all pictures
- Thank you for blacking out the name. This should be black though, to blend into the image. Dr. Chiu’s name should also be blacked out from ALL images
- Make sure that distance between text and bottom of image is uniform on all slides
- Logo is too big (see SNIS superion). Again, you did not use logo 3d effect