SPECIAL DESIGNED ROUTING DEVICE TO EASE ENDOSCOPİC TRANSFORAMINAL LUMBAR DISC SURGERY: A CADAVERIC STUDY
Journal Title: Journal of Turkish Spinal Surgery - Year 2019, Vol 30, Issue 3
Abstract
Background Data: Fully endoscopic lumbar disc (FELD) surgery via transforaminal (TF) approach may be more demanding to adopt for surgeons experienced with conventional microdiscectomy, due to the necessity of a new anatomic orientation and understanding. We designed a routing device to facilitate access to safe anatomic triangle defined by Kambin at the level of foramen in cadavers. Purpose: To show that the transforaminal route for endoscopic lumbar disc herniations is safely applicable with the aid of a new routing device. Materials and Methods: Ten cadavers between the ages 18-75, with no history of lumbar spinal surgery or trauma, with previous abdominal computed tomography (CT) scans included in our study. Postmortem abdominal CT scans were performed. Images were examined and transforaminal entrance angles without causing damage to retroperitoneal structures for each lumbar disc space and anatomical differences were recorded. TF approach was performed in cadavers using the angles measured from abdominal CTs and the entry point determined with the help of routing device. Results: L1-L2, L2-L3, L3-L4, L4-L5 disc spaces were operated in ten cadavers. Kambin’s triangle was successfully reached with help of routing device using data obtained from CT (X’, α) and C-arm fluoroscopy (X, Y, Y’). Y’ marker with protractor on routing device, and the metal rod on this Y’ marker with an opening through which only the punction needle could pass were very important in reaching the target. The metal bar horizontal movement and fixation to this mechanism contributed to operation of device. Entrance points and angles calculated with the help of CT scans were found to be compatible with the images obtained from fluoroscopy and endoscopy during operation. Conclusions: In this study, it has been showed that TF approach can be safely performed with help of the new designed routing device.
Authors and Affiliations
Burcu GÖKER, Alican TAHTA, Ali Güven YÖRÜKOĞLU, Mehmet Osman AKÇAKAYA, Fahir ŞENCAN, Aydın AYDOSELİ, Altay SENCER, Talat KIRIŞ, Ali Tuncay CANBOLAT
Keywords
Related Articles
- EP ID EP677071
- DOI -
- Views 174
- Downloads 0
OSSIFIED THORACIC SPINAL MENINGIOMA: A CASE REPORT
Objective: To present a new case of an ossified spinal meningioma which is extremely uncommon patology, gives a sense of a real cancellous bone in surgery and to emphasize the importance of the physical shape of the t...
NEUROMUSCULAR SCOLIOSIS
Spinal deformity is a common and important consequence of many neuromuscular disorders. Spinal deformity that results from neuromuscular disease can be characterized by shared features including deformity pattern, natura...
POTT'S DİSEASE
24 patienîs were treated at the Wolfgang Goethe University Offenbach City Hospital between 1992 and 1996 for tubercuiosis of the spine. A high index of suspicion is required for Pott's disease, which occurs in fewer than...
GIANT ANTERIOR CERVICAL OSTEOPHYTES: A CASE REPORT
Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by ossification of the anterior longitudinal ligament of the spine and various extra-spinal ligaments. In this article, a 65-year-old male patient with gia...
IATROGENIC LUMBAR INTRASPINAL EPIDERMOID TUMOR IN ADULTS: 2 CASE REPORTS AND LITERATURE REVIEW
Iatrogenic lumbar tumors are usually occur in childhood, through implantation of epidermal cells to the intraspinal space during repetitive lumbar puncture. Cells iatrogenically implanted into the spinal canal during lum...