PaGe content:

  • Animation of full-endoscopic lateral recess stenosis decompression:

  • Where on the back is the small skin incision made for decompression ?

  • How is central widening performed through the one small 8mm skin incision ?

  • What does central canal widening look like on CT scan ?

  • Literature: some scientific articles:

Animation of full-endoscopic lateral recess stenosis decompression:

Where on the back is the small skin incision made for decompression ?

The skin incision for decompression is always in the middle of the lower back.

Hoe wordt een centrale verbreding uitgevoerd via die ene kleine 8mm huidincisie ? 

Zijdelings =rechtdoor 

Through the endoscope, bone growths and yellow ligament thickening on one side are removed to widen the lateral recessus.

Centraal = endoscoop rechtdoor +  kantelen

By tilting the endoscope, one small 8-mm skin incision allows the narrowed spinal canal to be widened on both the left and right. The entire canal is opened up.

What does central canal decompression look like on CT scan ? 

CT scan van L4-L5: linker foto toont zeer sterk vernauwd kanaal, rechter foto toont de bekomen ruimte winst met een full-endoscopische centraal kanaal verbreding (rode pijltjes markeren binnendiameter van het ruggenmerg kanaal)

Literature: some scientific articles:

Ruetten, Sebastian, Martin Komp, Harry Merk, en Georgios Godolias. ‘Full-Endoscopic Interlaminar and Transforaminal Lumbar Discectomy Versus Conventional Microsurgical Technique: A Prospective, Randomized, Controlled Study’. Spine 33, nr. 9 (april 2008): 931–39. https://doi.org/10.1097/BRS.0b013e31816c8af7.

  1. Ruetten, Sebastian, Martin Komp, Harry Merk, en Georgios Godolias. ‘Surgical Treatment for Lumbar Lateral Recess Stenosis with the Full-Endoscopic Interlaminar Approach versus Conventional Microsurgical Technique: A Prospective, Randomized, Controlled Study’. Journal of Neurosurgery: Spine, mei 2009, 476–85. https://doi.org/10.3171/2008.7.17634.

  2. Telfeian, Albert E., Anand Veeravagu, Adetokunbo A. Oyelese, en Ziya L. Gokaslan. ‘A Brief History of Endoscopic Spine Surgery’. Neurosurgical Focus, februari 2016, E2. https://doi.org/10.3171/2015.11.FOCUS15429.

  3. Lee, Chul-Woo, Kang-Jun Yoon, en Sang-Soo Ha. ‘Comparative Analysis between Three Different Lumbar Decompression Techniques (Microscopic, Tubular, and Endoscopic) in Lumbar Canal and Lateral Recess Stenosis: Preliminary Report’. BioMed Research International 2019 (24 maart 2019): 1–11. https://doi.org/10.1155/2019/6078469.

  4. Fujimoto, Toru, Takuya Taniwaki, Shogo Tahata, Takayuki Nakamura, en Hiroshi Mizuta. ‘Patient Outcomes for a Minimally Invasive Approach to Treat Lumbar Spinal Canal Stenosis: Is Microendoscopic or Microscopic Decompressive Laminotomy the Less Invasive Surgery?’ Clinical Neurology and Neurosurgery 131 (april 2015): 21–25. https://doi.org/10.1016/j.clineuro.2015.01.014.

  5. Hasan, Saqib, Lynn B. McGrath, Rajeev D. Sen, Jason K. Barber, en Christoph P. Hofstetter. ‘Comparison of Full-Endoscopic and Minimally Invasive Decompression for Lumbar Spinal Stenosis in the Setting of Degenerative Scoliosis and Spondylolisthesis’. Neurosurgical Focus 46, nr. 5 (mei 2019): E16. https://doi.org/10.3171/2019.2.FOCUS195.

  6. Ito, Fujio, Zenya Ito, Motohide Shibayama, Shu Nakamura, Minoru Yamada, Hideki Yoshimatu, Mikinobu Takeuchi, Kenzo Shimizu, en Yasushi Miura. ‘Step-by-Step Sublaminar Approach With a Newly-Designed Spinal Endoscope for Unilateral-Approach Bilateral Decompression in Spinal Stenosis’. Neurospine 16, nr. 1 (31 maart 2019): 41–51.

  7. Kim, Hyeun Sung, Byapak Paudel, Ji Soo Jang, Seong Hoon Oh, Sol Lee, Jae Eun Park, en Il Tae Jang. ‘Percutaneous Full Endoscopic Bilateral Lumbar Decompression of Spinal Stenosis Through Uniportal-Contralateral Approach: Techniques and Preliminary Results’. World Neurosurgery 103 (juli 2017): 201–9. https://doi.org/10.1016/j.wneu.2017.03.130.

  8. Kitagawa, Takahiro, Yoji Ogura, Yoshiomi Kobayashi, Yoshiyuki Takahashi, Yoshiro Yonezawa, Kodai Yoshida, Yohei Takahashi, Akimasa Yasuda, Yoshio Shinozaki, en Jun Ogawa. ‘Improvement of Lower Back Pain in Lumbar Spinal Stenosis After Decompression Surgery and Factors That Predict Residual Lower Back Pain’. Global Spine Journal 11, nr. 2 (maart 2021): 212–18. https://doi.org/10.1177/2192568220905617.

  9. Lee, Chang-Hyun, Miyoung Choi, Dal Sung Ryu, Il Choi, Chi Heon Kim, Hyeun Sung Kim, en Moon-Jun Sohn. ‘Efficacy and Safety of Full-Endoscopic Decompression via Interlaminar Approach for Central or Lateral Recess Spinal Stenosis of the Lumbar Spine: A Meta-Analysis’. SPINE 43, nr. 24 (december 2018): 1756–64. https://doi.org/10.1097/BRS.0000000000002708.

  10. Lee, Chul-Woo, Kang-Jun Yoon, en Ji-Ho Jun. ‘Percutaneous Endoscopic Laminotomy with Flavectomy by Uniportal, Unilateral Approach for the Lumbar Canal or Lateral Recess Stenosis’. World Neurosurgery 113 (mei 2018): e129–37. https://doi.org/10.1016/j.wneu.2018.01.195.

  11. Moisi, Marc, Christian Fisahn, Lara Tkachenko, R. Shane Tubbs, Daniel Ginat, Peter Grunert, Shiveindra Jeyamohan, e.a. ‘Unilateral Laminotomy with Bilateral Spinal Canal Decompression for Lumbar Stenosis: A Technical Note’. Cureus, 27 mei 2016. https://doi.org/10.7759/cureus.623.

  12. Movassaghi, Kamran, Bryce A. Basques, Philip K. Louie, Jannat M. Khan, Peter B. Derman, Michael T. Nolte, Justin C. Paul, Edward J. Goldberg, en Howard S. An. ‘The Duration of Symptoms Does Not Impact Clinical Outcomes Following Lumbar Decompression Surgery’: SPINE 44, nr. 5 (maart 2019): 305–8. https://doi.org/10.1097/BRS.0000000000002818.

  13. The Duration of Symptoms Does Not Impact Clinical Outcomes Following Lumbar Decompression Surgery’: SPINE 44, nr. 5 (maart 2019): 305–8. https://doi.org/10.1097/BRS.0000000000002818.

  14. Ogink, Paul T., Olivier van Wulfften Palthe, Teun Teunis, Christopher M. Bono, Mitchell B. Harris, Joseph H. Schwab, en Thomas D. Cha. ‘Practice Variation Among Surgeons Treating Lumbar Spinal Stenosis in a Single Institution’: SPINE 44, nr. 7 (april 2019): 510–16. https://doi.org/10.1097/BRS.0000000000002859.

  15. Practice Variation Among Surgeons Treating Lumbar Spinal Stenosis in a Single Institution’: SPINE 44, nr. 7 (april 2019): 510–16. https://doi.org/10.1097/BRS.0000000000002859.

  16. Siepe, Christoph J., Daniel Sauer, en H. Michael Mayer. ‘Full Endoscopic, Bilateral over-the-Top Decompression for Lumbar Spinal Stenosis’. European Spine Journal 27, nr. S4 (juli 2018): 563–65. https://doi.org/10.1007/s00586-018-5656-3.

  17. Soliman, Hesham Magdi. ‘Irrigation Endoscopic Decompressive Laminotomy. A New Endoscopic Approach for Spinal Stenosis Decompression’. The Spine Journal 15, nr. 10 (oktober 2015): 2282–89. https://doi.org/10.1016/j.spinee.2015.07.009.

  18. Staartjes, Victor E., en Marc L. Schröder. ‘Effectiveness of a Decision-Making Protocol for the Surgical Treatment of Lumbar Stenosis with Grade 1 Degenerative Spondylolisthesis’. World Neurosurgery 110 (februari 2018): e355–61. https://doi.org/10.1016/j.wneu.2017.11.001.

  19. Storzer, Bastian, en Klaus John Schnake. ‘Microscopic Bilateral Decompression by Unilateral Approach in Spinal Stenosis’. European Spine Journal 25, nr. S2 (augustus 2016): 270–71. https://doi.org/10.1007/s00586-016-4479-3.

  20. Torudom, Yingyong, en Thitinut Dilokhuttakarn. ‘Two Portal Percutaneous Endoscopic Decompression for Lumbar Spinal Stenosis: Preliminary Study’. Asian Spine Journal 10, nr. 2 (2016): 335. https://doi.org/10.4184/asj.2016.10.2.335.

  21. Toyoda, Hiromitsu, Hiroaki Nakamura, Sadahiko Konishi, Sho Dohzono, Minori Kato, en Hideki Matsuda. ‘Clinical Outcome of Microsurgical Bilateral Decompression via Unilateral Approach for Lumbar Canal Stenosis: Minimum Five-Year Follow-Up’. Spine 36, nr. 5 (maart 2011): 410–15. https://doi.org/10.1097/BRS.0b013e3181d25829.

  22. Ulrich, Nils H., Jakob M. Burgstaller, Giuseppe Pichierri, Maria M. Wertli, Mazda Farshad, François Porchet, Johann Steurer, en Ulrike Held. ‘Decompression Surgery Alone Versus Decompression Plus Fusion in Symptomatic Lumbar Spinal Stenosis: A Swiss Prospective Multicenter Cohort Study With 3 Years of Follow-Up’. SPINE 42, nr. 18 (september 2017): E1077–86. https://doi.org/10.1097/BRS.0000000000002068.

  23. Wada, K., K. Sairyo, T. Sakai, en N. Yasui. ‘Minimally Invasive Endoscopic Bilateral Decompression with a Unilateral Approach (Endo-BiDUA) for Elderly Patients with Lumbar Spinal Canal Stenosis’. Min - Minimally Invasive Neurosurgery 53, nr. 02 (april 2010): 65–68. https://doi.org/10.1055/s-0030-1247559.

  24. Wagner, Ralf, Albert E. Telfeian, Guntram Krzok, en Menno Iprenburg. ‘Fully-Endoscopic Lumbar Laminectomy for Central and Lateral Recess Stenosis: Technical Note’. Interdisciplinary Neurosurgery 13 (september 2018): 6–9. https://doi.org/10.1016/j.inat.2018.01.006.

Dr. Peter Van Daele, Endoscopic Spine Surgeon