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Atlas of Full-Endoscopic Spine Surgery.

By: Contributor(s): Material type: TextTextPublisher: New York : Thieme Medical Publishers, Incorporated, 2019Copyright date: ©2020Edition: 1st edDescription: 1 online resource (162 pages)Content type:
  • text
Media type:
  • computer
Carrier type:
  • online resource
ISBN:
  • 9781684200245
Subject(s): Genre/Form: Additional physical formats: Print version:: Atlas of Full-Endoscopic Spine SurgeryLOC classification:
  • RD768 .H647 2020
Online resources:
Contents:
Atlas of Full-Endoscopic Spine Surgery -- Title Page -- Copyright -- Dedication -- Contents -- Foreword by Richard G. Ellenbogen -- Foreword by Roger Härtl -- Preface -- Contributors -- Part 1: Introduction -- 1 Anesthesia and Rapid Recovery -- 1.1 Introduction -- 1.2 General Principles of Rapid Recovery -- 1.3 Key Components -- 1.4 Anesthesia Protocol -- 1.5 Summary -- 2 Radiation Safety in Full-Endoscopic Spine Surgery -- 2.1 Introduction -- 2.2 Occupational Radiation Guidelines -- 2.3 Radiation Safety -- 2.4 ALARA (As Low As Reasonably Achievable) Principle -- 2.4.1 Restrict the Area and Duration of Exposure -- 2.4.2 Get as Much Distance to the Radiation Source as Achievable -- 2.4.3 Protect Yourself against Radiation Exposure -- 2.5 Emerging Technologies -- 2.6 Conclusion -- 3 Essential Imaging in Full-Endoscopic Spine Surgery -- 3.1 Introduction -- 3.2 Features of Intraoperative Fluoroscopy -- 3.2.1 Magnification -- 3.2.2 Distortion -- 3.2.3 Parallax -- 3.3 Fundamental Fluoroscopic Images for Full-Endoscopic Spine Surgery -- 3.3.1 Lumbar Spine -- 3.3.2 Interlaminar Technique -- 3.3.3 Transforaminal Technique -- 3.4 Thoracic Spine -- 3.5 Cervical Spine -- 3.6 Conclusion -- 4 Intraoperative Navigation for Full-Endoscopic Spine Surgery -- 4.1 Case Example -- 4.2 Background -- 4.3 Indications for Intraoperative Navigation -- 4.4 Preoperative Planning and Positioning -- 4.5 Surgical Technique -- 4.6 Conclusion -- 4.7 Pearls and Pitfalls -- 5 Endoscopic Instruments -- 5.1 Introduction -- 5.2 Working-Channel Endoscope -- 5.2.1 Optical System -- 5.2.2 Illumination -- 5.2.3 Irrigation Channels -- 5.2.4 Working Channel -- 5.3 Illumination -- 5.4 Video Equipment -- 5.5 Fluid Pump -- 5.6 Surgical Instruments -- 5.6.1 Instruments for Targeting and Creating an Approach Corridor -- 5.6.2 Instruments to Maintain the Artificial Working Space.
5.6.3 Instruments for Dissection and Removing Tissue -- 5.6.4 Radiofrequency Instruments -- 5.6.5 Lasers -- 5.6.6 Motorized Instruments -- 5.6.7 Basic Surgical Instruments -- 6 Operating Room Setup: The Basics -- 6.1 Introduction -- 6.2 Operating Room Layout -- 6.3 Positioning -- 6.4 Equipment Setup -- 6.5 Operative Field -- 6.6 Staff -- 7 Applied Anatomy for Full-Endoscopic Spine Surgery -- 7.1 Cervical Spine Applied Anatomy -- 7.1.1 Posterior Fascia -- 7.1.2 Lamina and Ligamentum Flavum -- 7.1.3 Facet Joints and Intervertebral Foramen -- 7.2 Thoracic Spine Applied Anatomy -- 7.2.1 Lamina and Ligamentum Flavum -- 7.2.2 Facet Joints and Intervertebral Foramen -- 7.3 Lumbar Spine Applied Anatomy -- 7.3.1 Lamina and Ligamentum Flavum -- 7.3.2 Lateral Recess -- 7.3.3 Kambin's Triangle -- 7.3.4 Intervertebral Foramen -- 7.3.5 Pedicle Morphology -- 8 Principles of Full-Endoscopic Surgical Technique -- 8.1 Progression of Full-Endoscopic Spine Surgery -- 8.1.1 Radiographic Identification of Target Area -- 8.1.2 Transition from Imaging to Palpation -- 8.1.3 Transition from Palpation to Direct Visualization -- 8.2 Holding theWorking-Channel Endoscope -- 8.3 Utilizing the Tubular Retractor -- 8.4 Continuous Irrigation -- 8.5 Working with Tools via the Working Channel -- 8.6 Hemostasis -- 8.6.1 Areas of Frequent Bleeding -- 9 Essential Tasks of Full-Endoscopic Spine Surgery -- 9.1 Create aWorking Space -- 9.2 Defining a Bony Edge -- 9.3 Optimizing Off-Axis Reach -- 9.4 Resection of Soft Tissue in Line with Endoscope -- 9.5 Off-Axis Resection of Soft Tissue -- 9.6 Retraction of Neural Elements -- 9.7 Using the Drill -- 10 Preoperative DiagnosticWorkup -- 10.1 Introduction -- 10.2 History and Physical Examination -- 10.3 Imaging -- 10.4 Diagnostic Injections -- Part 2: Lumbar -- 11 Interlaminar Endoscopic Lateral Recess Decompression -- 11.1 Case Example.
11.2 Indications -- 11.3 Approach -- 11.4 Visualization of the Target Area -- 11.5 Hemilaminotomy -- 11.6 Enter Epidural Space -- 11.7 Identification of the Lateral Margin of Neural Elements -- 11.8 Lateral Recess Decompression -- 11.9 Retraction of Neural Elements -- 11.10 Ventral Decompression of Neural Elements -- 11.11 Pearls and Pitfalls -- 12 Interlaminar Endoscopic Lumbar Diskectomy -- 12.1 Case Example -- 12.2 Indications -- 12.3 Approach -- 12.3.1 Tissue Dilation and Placement of Working Tube -- 12.3.2 Visualization of the Target Area -- 12.3.3 Hemilaminotomy -- 12.4 Enter Epidural Space -- 12.4.1 Identify Lateral Margin of Neural Elements -- 12.4.2 Resection of Disk Sequester -- 12.4.3 Retraction of Neural Elements -- 12.4.4 Resection of Residual Disk Fragments and Exploration of the Annular Defect -- 12.5 Pearls and Pitfalls -- 13 Interlaminar Contralateral Endoscopic Lumbar Foraminotomy -- 13.1 Case Example -- 13.2 Indications -- 13.3 Approach -- 13.4 Identify Bony Landmarks -- 13.5 Laminotomy -- 13.6 Enter Epidural Space -- 13.7 Contralateral Recess Decompression -- 13.8 Contralateral Foraminotomy -- 13.9 Pearls and Pitfalls -- 14 Lumbar Endoscopic Unilateral Laminotomy for Bilateral Decompression -- 14.1 Case Example -- 14.2 Indications -- 14.3 Approach -- 14.4 Identification of Bony Landmarks -- 14.5 Laminotomy -- 14.6 Flavectomy -- 14.6.1 Lateral Recess Decompression -- 14.6.2 Mobilization of Neural Elements -- 14.7 Pearls and Pitfalls -- 15 Endoscopic Extraforaminal Lumbar Diskectomy -- 15.1 Case Example -- 15.2 Indications -- 15.3 Preoperative Planning -- 15.4 Approach -- 15.5 Identify Bony Landmarks -- 15.5.1 Foraminal Decompression -- 15.5.2 Extraforaminal Decompression -- 15.6 Pearls and Pitfalls -- 16 Transforaminal Endoscopic Lumbar Diskectomy -- 16.1 Case Example -- 16.2 Indications -- 16.3 Preoperative Planning.
16.4 Approach -- 16.5 Identify Bony Landmarks -- 16.6 Identify the Traversing Nerve Root -- 16.7 Resect the Disk Fragment -- 16.8 Inspect the Annular Defect -- 16.9 Pearls and Pitfalls -- 17 Trans-Superior Articular Process Endoscopic Lumbar Approach -- 17.1 Case Example -- 17.2 Indications -- 17.3 Preoperative Planning -- 17.4 Approach -- 17.5 Identify Bony Landmarks -- 17.5.1 Decompression of the Intervertebral Foramen -- 17.5.2 Decompression of the Lateral Recess -- 17.6 Pearls and Pitfalls -- 18 Transforaminal Endoscopic Lumbar Interbody Fusion -- 18.1 Indications -- 18.2 Approach and Access -- 18.3 Diskectomy and Endplate Preparation -- 18.3.1 Interbody Cage Placement and Osteobiologics -- 18.3.2 Percutaneous Screw Fixation and Spondylolisthesis Correction -- 18.3.3 Postoperative Care -- 18.4 Pearls and Pitfalls -- Part 3: Thoracic -- 19 Transforaminal Endoscopic Thoracic Diskectomy -- 19.1 Case Example -- 19.2 Indications -- 19.2.1 Operating Room Setup and Patient Position -- 19.2.2 Approach -- 19.3 Identify Bony Landmarks and Foraminoplasty -- 19.3.1 Delineate Dura-Disk Interface -- 19.3.2 Resect Disk Herniation -- 19.4 Pearls and Pitfalls -- Part 4: Cervical -- 20 Anterior Endoscopic Cervical Diskectomy -- 20.1 Case Example -- 20.2 Indications -- 20.3 Approach -- 20.4 Tissue Dilation and Placement of Working Tube -- 20.5 Diskectomy -- 20.6 Foraminotomy -- 20.7 Pearls and Pitfalls -- 21 Posterior Endoscopic Cervical Foraminotomy -- 21.1 Case Example -- 21.2 Indications -- 21.3 Approach -- 21.4 Identification of Bony Landmarks -- 21.5 Hemilaminotomy -- 21.6 Identify the Index-Level Nerve Root -- 21.7 Foraminal Decompression -- 21.8 Optional Partial Caudal Pedicle Resection -- 21.9 Optional Resection of Disk-Osteophyte Complex -- 21.10 Pearls and Pitfalls -- 22 Cervical Endoscopic Unilateral Laminotomy for Bilateral Decompression.
22.1 Case Example -- 22.2 Indications -- 22.3 Approach -- 22.4 Visualizing Target Area -- 22.5 Hemilaminotomy -- 22.6 Undercutting the Spinous Process -- 22.7 Contralateral Decompression -- 22.8 Pearls and Pitfalls -- Part 5: Additional Topics -- 23 Adapting Full-Endoscopic Technique for Challenging Cases -- 23.1 Morbidly Obese Patients -- 23.1.1 Case Example -- 23.1.2 Pearls and Pitfalls -- 23.2 Adapting the Transforaminal Approach for Caudally Migrated Disk Herniations -- 23.2.1 Case Example -- 23.2.2 Pearls and Pitfalls -- 23.3 Adapting the Transforaminal Approach for Rostrally Migrated Disk Herniations -- 23.3.1 Case Example -- 23.3.2 Pearls and Pitfalls -- 23.4 Resection of Synovial Cysts -- 23.4.1 Case Example -- 23.4.2 Pearls and Pitfalls -- 23.5 Transforaminal Access to L5/S1 in Patients with a High Iliac Crest -- 23.5.1 Case Example -- 23.5.2 Pearls and Pitfalls -- 24 Endoscopic Revision Surgery -- 24.1 Principles -- 24.2 Indications -- 24.3 Illustrative Cases -- 24.3.1 Interlaminar Endoscopic Lumbar Diskectomy Revision -- 24.3.2 Transforaminal Endoscopic Lumbar Diskectomy Revision -- 24.3.3 Interlaminar Endoscopic Lateral Recess Decompression Revision -- 24.3.4 Transforaminal Endoscopic Lateral Recess Decompression Revision -- 24.3.5 Interlaminar Endoscopic Approach for Resection of Retropulsed Interbody Cage -- 24.3.6 Transforaminal Endoscopic Thoracic Diskectomy Revision -- 24.3.7 Interlaminar Endoscopic Approach for Resection of Sacroiliac Bolt -- 25 Complications Associated with Full-Endoscopic Spine Surgery -- 25.1 Types of Complications -- 25.2 Dural Lacerations -- 25.2.1 Dural Lacerations Encountered during the Transforaminal Approach -- 25.2.2 Case Examples -- 25.2.3 Dural Lacerations Encountered during the Interlaminar Approach -- 25.2.4 Case Examples -- 25.3 Dural Lacerations in Full-Endoscopic Spine Surgery.
25.3.1 Clinical Symptoms.
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Atlas of Full-Endoscopic Spine Surgery -- Title Page -- Copyright -- Dedication -- Contents -- Foreword by Richard G. Ellenbogen -- Foreword by Roger Härtl -- Preface -- Contributors -- Part 1: Introduction -- 1 Anesthesia and Rapid Recovery -- 1.1 Introduction -- 1.2 General Principles of Rapid Recovery -- 1.3 Key Components -- 1.4 Anesthesia Protocol -- 1.5 Summary -- 2 Radiation Safety in Full-Endoscopic Spine Surgery -- 2.1 Introduction -- 2.2 Occupational Radiation Guidelines -- 2.3 Radiation Safety -- 2.4 ALARA (As Low As Reasonably Achievable) Principle -- 2.4.1 Restrict the Area and Duration of Exposure -- 2.4.2 Get as Much Distance to the Radiation Source as Achievable -- 2.4.3 Protect Yourself against Radiation Exposure -- 2.5 Emerging Technologies -- 2.6 Conclusion -- 3 Essential Imaging in Full-Endoscopic Spine Surgery -- 3.1 Introduction -- 3.2 Features of Intraoperative Fluoroscopy -- 3.2.1 Magnification -- 3.2.2 Distortion -- 3.2.3 Parallax -- 3.3 Fundamental Fluoroscopic Images for Full-Endoscopic Spine Surgery -- 3.3.1 Lumbar Spine -- 3.3.2 Interlaminar Technique -- 3.3.3 Transforaminal Technique -- 3.4 Thoracic Spine -- 3.5 Cervical Spine -- 3.6 Conclusion -- 4 Intraoperative Navigation for Full-Endoscopic Spine Surgery -- 4.1 Case Example -- 4.2 Background -- 4.3 Indications for Intraoperative Navigation -- 4.4 Preoperative Planning and Positioning -- 4.5 Surgical Technique -- 4.6 Conclusion -- 4.7 Pearls and Pitfalls -- 5 Endoscopic Instruments -- 5.1 Introduction -- 5.2 Working-Channel Endoscope -- 5.2.1 Optical System -- 5.2.2 Illumination -- 5.2.3 Irrigation Channels -- 5.2.4 Working Channel -- 5.3 Illumination -- 5.4 Video Equipment -- 5.5 Fluid Pump -- 5.6 Surgical Instruments -- 5.6.1 Instruments for Targeting and Creating an Approach Corridor -- 5.6.2 Instruments to Maintain the Artificial Working Space.

5.6.3 Instruments for Dissection and Removing Tissue -- 5.6.4 Radiofrequency Instruments -- 5.6.5 Lasers -- 5.6.6 Motorized Instruments -- 5.6.7 Basic Surgical Instruments -- 6 Operating Room Setup: The Basics -- 6.1 Introduction -- 6.2 Operating Room Layout -- 6.3 Positioning -- 6.4 Equipment Setup -- 6.5 Operative Field -- 6.6 Staff -- 7 Applied Anatomy for Full-Endoscopic Spine Surgery -- 7.1 Cervical Spine Applied Anatomy -- 7.1.1 Posterior Fascia -- 7.1.2 Lamina and Ligamentum Flavum -- 7.1.3 Facet Joints and Intervertebral Foramen -- 7.2 Thoracic Spine Applied Anatomy -- 7.2.1 Lamina and Ligamentum Flavum -- 7.2.2 Facet Joints and Intervertebral Foramen -- 7.3 Lumbar Spine Applied Anatomy -- 7.3.1 Lamina and Ligamentum Flavum -- 7.3.2 Lateral Recess -- 7.3.3 Kambin's Triangle -- 7.3.4 Intervertebral Foramen -- 7.3.5 Pedicle Morphology -- 8 Principles of Full-Endoscopic Surgical Technique -- 8.1 Progression of Full-Endoscopic Spine Surgery -- 8.1.1 Radiographic Identification of Target Area -- 8.1.2 Transition from Imaging to Palpation -- 8.1.3 Transition from Palpation to Direct Visualization -- 8.2 Holding theWorking-Channel Endoscope -- 8.3 Utilizing the Tubular Retractor -- 8.4 Continuous Irrigation -- 8.5 Working with Tools via the Working Channel -- 8.6 Hemostasis -- 8.6.1 Areas of Frequent Bleeding -- 9 Essential Tasks of Full-Endoscopic Spine Surgery -- 9.1 Create aWorking Space -- 9.2 Defining a Bony Edge -- 9.3 Optimizing Off-Axis Reach -- 9.4 Resection of Soft Tissue in Line with Endoscope -- 9.5 Off-Axis Resection of Soft Tissue -- 9.6 Retraction of Neural Elements -- 9.7 Using the Drill -- 10 Preoperative DiagnosticWorkup -- 10.1 Introduction -- 10.2 History and Physical Examination -- 10.3 Imaging -- 10.4 Diagnostic Injections -- Part 2: Lumbar -- 11 Interlaminar Endoscopic Lateral Recess Decompression -- 11.1 Case Example.

11.2 Indications -- 11.3 Approach -- 11.4 Visualization of the Target Area -- 11.5 Hemilaminotomy -- 11.6 Enter Epidural Space -- 11.7 Identification of the Lateral Margin of Neural Elements -- 11.8 Lateral Recess Decompression -- 11.9 Retraction of Neural Elements -- 11.10 Ventral Decompression of Neural Elements -- 11.11 Pearls and Pitfalls -- 12 Interlaminar Endoscopic Lumbar Diskectomy -- 12.1 Case Example -- 12.2 Indications -- 12.3 Approach -- 12.3.1 Tissue Dilation and Placement of Working Tube -- 12.3.2 Visualization of the Target Area -- 12.3.3 Hemilaminotomy -- 12.4 Enter Epidural Space -- 12.4.1 Identify Lateral Margin of Neural Elements -- 12.4.2 Resection of Disk Sequester -- 12.4.3 Retraction of Neural Elements -- 12.4.4 Resection of Residual Disk Fragments and Exploration of the Annular Defect -- 12.5 Pearls and Pitfalls -- 13 Interlaminar Contralateral Endoscopic Lumbar Foraminotomy -- 13.1 Case Example -- 13.2 Indications -- 13.3 Approach -- 13.4 Identify Bony Landmarks -- 13.5 Laminotomy -- 13.6 Enter Epidural Space -- 13.7 Contralateral Recess Decompression -- 13.8 Contralateral Foraminotomy -- 13.9 Pearls and Pitfalls -- 14 Lumbar Endoscopic Unilateral Laminotomy for Bilateral Decompression -- 14.1 Case Example -- 14.2 Indications -- 14.3 Approach -- 14.4 Identification of Bony Landmarks -- 14.5 Laminotomy -- 14.6 Flavectomy -- 14.6.1 Lateral Recess Decompression -- 14.6.2 Mobilization of Neural Elements -- 14.7 Pearls and Pitfalls -- 15 Endoscopic Extraforaminal Lumbar Diskectomy -- 15.1 Case Example -- 15.2 Indications -- 15.3 Preoperative Planning -- 15.4 Approach -- 15.5 Identify Bony Landmarks -- 15.5.1 Foraminal Decompression -- 15.5.2 Extraforaminal Decompression -- 15.6 Pearls and Pitfalls -- 16 Transforaminal Endoscopic Lumbar Diskectomy -- 16.1 Case Example -- 16.2 Indications -- 16.3 Preoperative Planning.

16.4 Approach -- 16.5 Identify Bony Landmarks -- 16.6 Identify the Traversing Nerve Root -- 16.7 Resect the Disk Fragment -- 16.8 Inspect the Annular Defect -- 16.9 Pearls and Pitfalls -- 17 Trans-Superior Articular Process Endoscopic Lumbar Approach -- 17.1 Case Example -- 17.2 Indications -- 17.3 Preoperative Planning -- 17.4 Approach -- 17.5 Identify Bony Landmarks -- 17.5.1 Decompression of the Intervertebral Foramen -- 17.5.2 Decompression of the Lateral Recess -- 17.6 Pearls and Pitfalls -- 18 Transforaminal Endoscopic Lumbar Interbody Fusion -- 18.1 Indications -- 18.2 Approach and Access -- 18.3 Diskectomy and Endplate Preparation -- 18.3.1 Interbody Cage Placement and Osteobiologics -- 18.3.2 Percutaneous Screw Fixation and Spondylolisthesis Correction -- 18.3.3 Postoperative Care -- 18.4 Pearls and Pitfalls -- Part 3: Thoracic -- 19 Transforaminal Endoscopic Thoracic Diskectomy -- 19.1 Case Example -- 19.2 Indications -- 19.2.1 Operating Room Setup and Patient Position -- 19.2.2 Approach -- 19.3 Identify Bony Landmarks and Foraminoplasty -- 19.3.1 Delineate Dura-Disk Interface -- 19.3.2 Resect Disk Herniation -- 19.4 Pearls and Pitfalls -- Part 4: Cervical -- 20 Anterior Endoscopic Cervical Diskectomy -- 20.1 Case Example -- 20.2 Indications -- 20.3 Approach -- 20.4 Tissue Dilation and Placement of Working Tube -- 20.5 Diskectomy -- 20.6 Foraminotomy -- 20.7 Pearls and Pitfalls -- 21 Posterior Endoscopic Cervical Foraminotomy -- 21.1 Case Example -- 21.2 Indications -- 21.3 Approach -- 21.4 Identification of Bony Landmarks -- 21.5 Hemilaminotomy -- 21.6 Identify the Index-Level Nerve Root -- 21.7 Foraminal Decompression -- 21.8 Optional Partial Caudal Pedicle Resection -- 21.9 Optional Resection of Disk-Osteophyte Complex -- 21.10 Pearls and Pitfalls -- 22 Cervical Endoscopic Unilateral Laminotomy for Bilateral Decompression.

22.1 Case Example -- 22.2 Indications -- 22.3 Approach -- 22.4 Visualizing Target Area -- 22.5 Hemilaminotomy -- 22.6 Undercutting the Spinous Process -- 22.7 Contralateral Decompression -- 22.8 Pearls and Pitfalls -- Part 5: Additional Topics -- 23 Adapting Full-Endoscopic Technique for Challenging Cases -- 23.1 Morbidly Obese Patients -- 23.1.1 Case Example -- 23.1.2 Pearls and Pitfalls -- 23.2 Adapting the Transforaminal Approach for Caudally Migrated Disk Herniations -- 23.2.1 Case Example -- 23.2.2 Pearls and Pitfalls -- 23.3 Adapting the Transforaminal Approach for Rostrally Migrated Disk Herniations -- 23.3.1 Case Example -- 23.3.2 Pearls and Pitfalls -- 23.4 Resection of Synovial Cysts -- 23.4.1 Case Example -- 23.4.2 Pearls and Pitfalls -- 23.5 Transforaminal Access to L5/S1 in Patients with a High Iliac Crest -- 23.5.1 Case Example -- 23.5.2 Pearls and Pitfalls -- 24 Endoscopic Revision Surgery -- 24.1 Principles -- 24.2 Indications -- 24.3 Illustrative Cases -- 24.3.1 Interlaminar Endoscopic Lumbar Diskectomy Revision -- 24.3.2 Transforaminal Endoscopic Lumbar Diskectomy Revision -- 24.3.3 Interlaminar Endoscopic Lateral Recess Decompression Revision -- 24.3.4 Transforaminal Endoscopic Lateral Recess Decompression Revision -- 24.3.5 Interlaminar Endoscopic Approach for Resection of Retropulsed Interbody Cage -- 24.3.6 Transforaminal Endoscopic Thoracic Diskectomy Revision -- 24.3.7 Interlaminar Endoscopic Approach for Resection of Sacroiliac Bolt -- 25 Complications Associated with Full-Endoscopic Spine Surgery -- 25.1 Types of Complications -- 25.2 Dural Lacerations -- 25.2.1 Dural Lacerations Encountered during the Transforaminal Approach -- 25.2.2 Case Examples -- 25.2.3 Dural Lacerations Encountered during the Interlaminar Approach -- 25.2.4 Case Examples -- 25.3 Dural Lacerations in Full-Endoscopic Spine Surgery.

25.3.1 Clinical Symptoms.

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