Technique of Percutaneous Transforaminal Endoscopic Discectomy for the Treatment of Lumbar Disc Herniation

Rama Shankar Gupta, Xiao-Tao Wu^*, Xin Hong, Arjun Sinkemani

Department of Spinal Surgery, Southeast University School of Medicine Affiliated Zhongda Hospital, Nanjing, China.

DOI: 10.4236/ojo.2015.57028                

Abstract

Percutaneous Transforaminal Endoscopic Discectomy is a minimally invasive surgery with little pain, less blood loss, less hospital stay and the surgery can be done in local anesthesia, which was started during late 20^th century. Kambin and Gellmann in 1973 in the United States and Hijikata in Japanin 1977 individually preformed posterolateral percutaneous nucleotomy for the resection of the nucleus pulposus and release of compressed exiting nerve root, which is now spreading through the world and many surgeons are developing their skill but it needs experience and patience for successful outcomes. Along with advanced instruments now the surgery can be performed only giving a small skin incision of 8 - 10 mm and is as effective as the conventional method of surgery and open microdiscectomy surgery for the treatment of symptomatic lumbar disc herniation. In this review, we are explaining the technique of minimally invasive Percutaneous Transforaminal Endoscopic Discectomy surgery along its advantages and complications which can be encountered while performing this technique.

Keywords

Lumbar Disc Herniation, Herniated Nucleus Pulposus, Percutaneous Transforaminal Endoscopic Discectomy, Nucleotomy, Root Injury, Safety Triangle

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	American English: Slipped Disk.
[2]	Dagenais, S., Caro, J. and Haldeman, S. (2008) A Systematic Review of Low-back Pain Cost of Illness Studies in the United States and Internationally. The Spine Journal, 8, 8-20. http://dx.doi.org/10.1016/j.spinee.2007.10.005
[3]	Mixter, W. and Barr, J. (1934) Rupture of the Intervertebral Disc with Involvement of the Spinal Canal. The New England Journal of Medicine, 211, 210-215. http://dx.doi.org/10.1056/NEJM193408022110506
[4]	Caspar, W. (1977) A New Surgical Procedure for Lumbar Disk Herniation Causing Less Tssue Damage through a Microsurgical Approach. Advances in Neurosurgery, 4, 74-77.
[5]	Foley, K.T. and Smith, M.M. (1997) Microendoscopic Approach to Far-Lateral Lumbar Disc Herniation. Techniques in Neurosurgery, 3, 301-307.
[6]	Ddestandeau, J. (2004) Technique Features of Endoscopic Surgery for Lumbar Disc Herniation: 191 Patients. Neurochirurgie, 50, 6-10.
[7]	Kambin, P. and Gellman, H. (1983) Percutaneous Lateral Discectomy of the Lumbar Spine: A Preliminary Report. Clinical Orthopaedics and Related Research, 174, 127-132. http://dx.doi.org/10.1097/00003086-198304000-00015
[8]	Hijikata, S. (1989) Percutaneous Nucleotomy. A New Concept Techinque and 12 Years’ Experience. Clinical Orthopaedics and Related Research, 238, 9-23.
[9]	Forst, R. and Hausmann, B. (1983) Nucleoscopy—A New Examination Technique. Archives of Orthopaedic and Trauma Surgery, 101, 219-221. http://dx.doi.org/10.1007/BF00436774
[10]	Yeung, A.T. (2000) The Evolution of Percutaneous Spinal Endoscopy and Discectomy: State of the Art. Mount Sinai Journal of Medicine, 67, 327-332.
[11]	Yeung, A.T. and Tsou, P.M. (2002) Posterolateral Endoscopic Excision for Lumbar Disc Herniation: Surgical Technique, Outcome, and Complications in 307 Consecutive Cases. Spine, 27, 722-731.
[12]	Yeung, A.T. and Yeung, C.A. (2007) Minimally Incasive Technique for the Management of Lumbar Disc Herniation. Orthopedic Clinics of North America, 38, 363-372. http://dx.doi.org/10.1016/j.ocl.2007.04.005
[13]	Lee, S., Kim, S.K., Lee, S.H., Kim, W.J., Choi, W.C., Choi, G. and Shin, S.W. (2007) Percutaneous Endoscopic Lumbar Discectomy for Migrated Disc Herniation: Classification of Disc Migration and Surgical Approaches. European Spine Journal, 16, 431-437. http://dx.doi.org/10.1007/s00586-006-0219-4
[14]	Dezawa, A., Mikami, H. and Sairyo, K. (2011) Percutaneous Endoscopic Translaminar Approach for Herniated Nucleus Pulposus in the Hidden Zone of the Lumbar Spine. Asian Journal of Endoscopic Surgery, 5, 200-203.
[15]	Lee, S.H., Kang, H.S., Choi, G., Kong, B.J., Ahn, Y., Kim, J.S. and Lee, H.Y. (2010) Foraminoplastic Ventral Epidural Approach for Removal of Extruded Herniated Fragment at the L5-S1 Level. Neurologia Medico-Chirurgica (Tokyo), 50, 1074-1078. http://dx.doi.org/10.2176/nmc.50.1074
[16]	Sasani, M., Ozer, A.F., Oktenoglu, T., Canbulat, N. and Sarioglu, A.C. (2007) Percutaneous Endoscopic Discectomy for Far Lateral Lumbar Disc Herniations: Prospective Study and Outcome of 66 Patients. Minimally Invasive Neurosurgery, 50, 91-97. http://dx.doi.org/10.1055/s-2007-984383
[17]	Kitagawa, Y., Sairyo, K., Shibuya, I., Kitahama, Y., Kanamori, Y., Koga, S., Matsumoto, H., Sumita, T., Yamada, A. and Dezawa, A. (2012) Minimally Invasive and Simultaneous Removal of Herniated Intracanal and Extracanal Lumbar Nucleus Pulposus with a Percutaneous Spianal Endoscope. Asian Journal of Endoscopic Surgery, 5, 183-186. http://dx.doi.org/10.1111/j.1758-5910.2012.00144.x
[18]	Rutten, S., Komp, M. and Godolias, G. (2005) An Extreme Lateral Access for the Surgery of Lumbar Disc Herniation Inside the Spinal Canal Using the Full-Endoscopic Uniportal Transforaminal Approach-Technique and Prospective Results of 463 Patients. Spine, 30, 2570-2578. http://dx.doi.org/10.1097/01.brs.0000186327.21435.cc
[19]	Rutten, S., Komp, M., Merk, H. and Godolias, G. (2009) Recurrent Lumbar Disc Herniation after Conventional Discectomy: A Prospective, Randomized Study Comparing Full-Endoscopic Interlaminar and Transforaminal versus Microsurgical Revision. Journal of Spinal Disorders & Techniques, 22, 122-129. http://dx.doi.org/10.1097/BSD.0b013e318175ddb4
[20]	Shin, K.H., Chang, H.G., Rhee, N.K. and Lim, K.S. (2011) Revisional Percutaneous Full Endoscopic Disc Surgery for Recurrent Herniation of Previous Open Lumbar Discectomy. Asian Spine Journal, 5, 1-9. http://dx.doi.org/10.4184/asj.2011.5.1.1
[21]	Rutten, S., Komp, M., Merk, H. and Godolias, G. (2008) Full-Endoscopic Interlaminar and Transforaminal Lumbar Discectomy versus Conventional Microsurgical Technique: A Prospective, Randomized, Controlled Study. Spine, 33, 931-939. http://dx.doi.org/10.1097/BRS.0b013e31816c8af7
[22]	Birkenmaier, C., Komp, M., Leu, H.F., Wegener, B. and Rutten, S. (2013) The Current State of Endoscopic Disc Surgery: Review of Controlled Studies Comparing Full-Endoscopic Procedures for Disc Herniations to Standard Procedures. Pain physician, 16, 335-344.
[23]	Knight, M., Goswami, A. and Patko, J.T. (1999) Endoscopic Laser Foraminoplasty and an Aware-Stat Surgery: A Treatment Concept and 2-Year Outcome Analyses. Arthoskopie, 12, 62-73. http://dx.doi.org/10.1007/s001420050074
[24]	Knight, M.T., Goswami, A., Patko, J.T., et al. (2001) Endoscopic Foraminoplasty: A Prospective Study on 250 Consecutive Patients with Independent Evaluation. Journal of Clinical Laser Medicine & Surgery, 19, 73-81. http://dx.doi.org/10.1089/104454701750285395
[25]	Haag, M. (1999) Transforaminal Endoscopic Microdiscectomy. Indications and Short-Term to Intermediate-Term Results. Orthopade, 28, 615-621.
[26]	Kafadar, A., Kahraman, S. and Akboru, M. (2006) Percutaneous Endoscopic Transforaminal Lumbar Discectomy: A critical Appraisal. Minimally Invasive Neurosurgery, 49, 74-79. http://dx.doi.org/10.1055/s-2006-932184
[27]	Kim, M.J., Lee, S.H. and Jung, E.S. (2007) Targeted Percutaneous Transforaminal Endoscopic Diskectomy in 295 Patients: Comparison with Results of Microscopic Diskectomy. Surgical Neurology, 68, 623-631. http://dx.doi.org/10.1016/j.surneu.2006.12.051
[28]	Shim, Y.B., Lee, N.Y. and Huh, SH. (2007) Endoscopic Spinal Surgery for Herniated Lumbar Discs. Journal of Korean Neurosurgical Society, 41, 241-245. http://dx.doi.org/10.3340/jkns.2007.41.4.241
[29]	Tzaan, W.C. (2007) Transforaminal Percutaneous Endoscopic Lumbar Discectomy. Chang Gung Medical Journal, 30, 226-234.
[30]	Choi, G., Kang, H.Y., Modi, H.N., Prada, N., Nicolau, R.J., Joh, J.Y., Pan, W.J. and Lee, S.H. (2011) Risk of Developing Seizure after Percutaneous Endoscopic Lumbar Discectomy. Journal of Spinal Disorders & Techniques, 24, 83-92. http://dx.doi.org/10.1097/BSD.0b013e3181ddf124
[31]	Ruetten, S., Komp, M., Hahn, P. and Oezdemir, S. (2013) Decompression of Lumbar Lateral Spinal Stenosis: Full-Endoscopic, Interlaminar Technique. Operative Orthopadie und Traumatologie, 25, 31-46. http://dx.doi.org/10.1007/s00064-012-0195-2
[32]	Sairyo, K., Kitagawa, Y. and Dezawa, A. (2013) Percutaneous Endoscopic Discectomy and Thermalan-Nuloplasty for Professional Athletes. Asian Journal of Endoscopic Surgery, 6, 292-297. http://dx.doi.org/10.1111/ases.12055
[33]	Tsou, P.M., Alan Yeung, C. and Yeung, A.T. (2004) Postero-Lateral Transforaminal Selective Endoscopic Discectomy and Thermal Annuloplasty for Chronic Lumbar Discogenic Pain: Aminimal Access Visualized Intradiscal Surgical Procedure. The Spine Journal, 4, 564-573. http://dx.doi.org/10.1016/j.spinee.2004.01.014