Original Article

Percutaneous Endoscopic Surgical Approach For The Hidden Zone In Lumbar And Cervical Spine

A Dezawa

Citation

A Dezawa. Percutaneous Endoscopic Surgical Approach For The Hidden Zone In Lumbar And Cervical Spine. The Internet Journal of Minimally Invasive Spinal Technology. 2010 Volume 4 Number 1.

Abstract

Objective. To describe a percutaneous endoscopic surgical approach for disc herniations and foraminal stenosis in the “hidden zone.” Many spine surgeons have suggested different surgical approaches for symptomatic preforaminal and foraminal disc herniations and foraminal stenosis . However, almost every surgical approach has certain shortcomings when it comes to exposing the “hidden zone” without causing some degree of spinal instability.Methods.From 2007 to 2009, Twenty-nine patients with preforaminal and foraminal disc herniation and foraminal stenosis underwent surgical treatment via a percutaneous endoscopic translaminar approach. In all cases, the disc herniation was purely preforaminal, or mixed preforaminal and foraminal, while extraforaminal HNP were excluded from the present series. Among the 29patients, there were 15men and 14women (mean age, 59 years; range, 38–78 years). The affected levels were L3/L4 in 6patients, L4/L5 in15 patients, L5/S1 in 7 patients, C5/6 in 3patients and C6/7 in 2patients. There were 1recurrent disc herniations, the patients had already been operated at the same level.Results.Excellent results were obtained in 17 patients and good results in 12patients according to modified Manab’s criteria. All patients resumed their occupations within 10 to 30days after the operation depending on the type of work. Clinical follow-up and plain anteroposterior, lateral, and flexion extension views were performed at 3,6 and 12 months.Additionally, no radiograph signs of instability were present at the operative level. Every patient had a clinical evaluation yearly, and nobody complained of clinical signs of instability.Conclusions.A Percutaneous endoscopic surgical approach seem to be an acceptable surgical method for accessing a preforaminal disc herniation and foraminal stenosis, this technique has proven to be safe and did not cause any instability at the latest follow-up

 

References

Author Information

Akira Dezawa

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