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AR-S6524-051-210

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Spine

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Procedure

Dies ist eine leistungsstarke Behandlungsoption für alle Arten von Bandscheibenvorfällen im Bereich der Brustwirbelsäule, bei gleichzeitig signifikanter Minimierung von Begleiterscheinungen, Blutverlust, postoperativen Schmerzen und Manipulationen des Rückenmarks.1-4 Es handelt sich um die einzige Methode, die eine ungehinderte Sicht auf den ventralen Spinalkanal der Brustwirbelsäule ermöglicht, ohne dass umfangreiche Knochenresektionen vorgenommen werden müssen und ohne einen Zugang zum Brustraum erforderlich ist.
Literatur
1. Bae J. Chachan S. Shin SH, Lee SH. Transforaminal endoscopic thoracic discectomy with foraminoplasty for the treatment of thoracic disc herniation. J Spine Surg. 2020:6(2):397-404. doi:10.21037/iss.2019.11.19
2. Komp M. Ruetten S. Full-endoscopic anterior excision of thoracic disc herniations, including giant and calcified discs with spinal cord compression: surgical technique and outcomes. Eur Spine J. 2023.32(8):2685-2693. doi:10.1007/00586-023-07807-0
3. Konakondia S, Sofoluke N, Barber SM, Rimini SA, Siotkin JR. Outpatient endoscopic resection of large calcified thoracic disc herniation with caudal displacement. Neurosurg Focus Video. 2022:6(1):V/18. doi:10.3171/2021.10.FOCVID2112
4. Telfeian AE, Wagner R. Transforaminal endoscopic thoracic discectomy, surgical technique. J Spine Surg. 2023:9(2):166-175. doi:10.21037/ss-22-109

Endoskopische thorakale transforaminale Diskektomie

Child (D)

Die klassische offene Behandlung von weit lateralen Bandscheibenvorfällen im Bereich L5-S1 ist anspruchsvoll. Alternativ setzt der transforaminale endoskopische Zugang direkt am weit lateralen Bereich an und erfordert nur eine geringe oder gar keine Facettenresektion, um eine Dekompression zu erreichen.

Endoskopische weit laterale lumbale transforaminale Diskektomie

The ultra-minimally invasive trans-SAP approach provides a targeted corridor for accessing foraminal and lateral recess pathology, as well as cranial disc extrusions, particularly when facet anatomy or pathology limits a direct trajectory beneath the superior articular process. 1,2&nbsp;
 
References
 
1. Lee S, Kim SK, Lee SH, et al. Percutaneous endoscopic lumbar discectomy for migrated disc herniation: classification of disc migration and surgical approaches. Eur Spine J. 2007;16(3):431-437. doi:10.1007/s00586-006-0219-4
2. Lewandrowski KU, Telfeian AE, Hellinger S, et al. Difficulties, challenges, and the learning curve of avoiding complications in lumbar endoscopic spine surgery. Int J Spine Surg. 2021;15(suppl 3):S21-S37. doi:10.14444/8161

Trans-SAP Endoscopic Lumbar Discectomy

Eine transforaminale oder paraspinale Vorgehensweise bietet die Möglichkeit, weit lateral gelegene Bandscheibenvorfälle zu erreichen. Durch die Verwendung einer wirbelsäulenspezifischen Endoskopieoptik werden Weichteilverletzungen minimiert, was zu weniger postoperativen Schmerzen führt.1,2 Darüber hinaus haben Studien gezeigt, dass etwa 85 % der Patienten, die sich einer endoskopischen lumbalen Diskektomie unterzogen haben, bereits nach 6 bis 8 Wochen wieder sportlich aktiv waren.3,4
References
1. Sairyo&nbsp;K, Matsuura T,&nbsp;Higashino&nbsp;K, et al. Percutaneous endoscopic lumbar&nbsp;discectomy for athletes. J Spine. 2013;S5(006):1-4. doi:10.4172/2165-7939.S5-006&nbsp;​
2. Sivakanthan&nbsp;S, Williams JR,&nbsp;Feroze&nbsp;AH, et al. Endoscopic spine surgery in&nbsp;athletes: case series and review of literature. World&nbsp;Neurosurg. 2021;145:702-707. doi:10.1016/j.wneu.2020.08.211
3. Polikandriotis&nbsp;JA, Hudak EM, Perry MW. Minimally invasive surgery through&nbsp;endoscopic laminotomy and foraminotomy for the treatment of lumbar spinal&nbsp;stenosis. J&nbsp;Orthop. 2013;10(1):13-16. doi:10.1016/j.jor.2013.01.006
4. Ruetten&nbsp;S,&nbsp;Komp&nbsp;M, Merk H,&nbsp;Godolias&nbsp;G. Use of newly developed instruments&nbsp;and endoscopes: Full-endoscopic resection of lumbar disc herniations via the&nbsp;interlaminar and lateral transforaminal approach. J&nbsp;Neurosurg&nbsp;Spine.&nbsp;2007;6(6):521-530. doi:10.3171/spi.2007.6.6.2

Transforaminale endoskopische Diskektomie

Minimally invasive endoscopic cervical foraminotomy and decompression is designed to treat cervical radiculopathy and other conditions that compress the nerve root. Utilizing an endoscope, surgeons can directly visualize and remove compressive pathology such as disc herniations, osteophytes, and hypertrophic ligaments. This technique minimizes soft-tissue disruption, reduces blood loss, allows for quicker recovery, and has demonstrated high clinical success rates, with a systematic review reporting 91.3% overall and up to 94.2% for posterior approaches.1,2 Additionally, long-term follow-ups show lasting symptom relief, high patient satisfaction, and a lower risk of adjacent segment disease compared to traditional ACDF surgery.3
Potential applications include treatment of cervical radiculopathy, herniated cervical discs, cervical spondylosis, foraminal stenosis, and osteophytes (bone spurs). Research supports its effectiveness in treating both soft disc herniations, where the nucleus pulposus compresses the nerve root, and hard disc herniations caused by calcified disc material.4 A lower incidence of spinal instability has also been reported, suggesting a reduced need for future spinal fusion procedures.5
Careful patient selection is key to optimal surgical outcomes; those with major deformity, instability, or large central herniations may require alternative surgery. With proper selection and advancing technology, this method remains a safe, effective, and motion-preserving option for cervical nerve decompression.1
References
1. Huang CC, Fitts J, Huie D, Bhowmick DA, Abd-El-Barr MM. Evolution of cervical endoscopic spine surgery: current progress and future directions—a narrative review.&nbsp;J Clin Med.&nbsp;2024;13(7):2122. doi:10.3390/jcm13072122
2. Alomar SA, Maghrabi Y, Baeesa SS, Alves ÓL. Outcome of anterior and posterior endoscopic procedures for cervical radiculopathy due to degenerative disk disease: a systematic review and meta-analysis.&nbsp;Global Spine J.&nbsp;2022;12(7):1546-1560. doi:10.1177/2192568221103727
3. Kim HS, Wu PH, Tze-Chun Lau E, Jang IT. Narrative review of uniportal posterior endoscopic cervical foraminotomy.&nbsp;World Neurosurg.&nbsp;2024;181:148-153. doi:10.1016/j.wneu.2023.10.021
4. Bergamaschi JPM, Brito MBS, Araújo FF, et al. Surgical technique of central and over-the-top full-endoscopic decompression of the cervical spine: a technical note.&nbsp;J Pers Med.&nbsp;2023;13(10):1508. doi:10.3390/jpm13101508
5. Zhang C, Wu J, Zheng W, Li C, Zhou Y. Posterior endoscopic cervical decompression: review and technical note.&nbsp;Neurospine.&nbsp;2020;17(Suppl 1):S74-S80. doi:10.14245/ns.2040166.083

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AR-S6524-051-210

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