Columna vertebral

Discectomía endoscópica interlaminar

El enfoque endoscópico de las discectomías interlaminares proporciona un acceso mínimamente invasivo a las hernias posteriores de la columna lumbar inferior a las que puede resultar difícil acceder mediante un abordaje transforaminal. Además, la discectomía interlaminar produce menos alteraciones tisulares y musculares, tiempos de recuperación más breves y un retorno y un retorno mas rápido a las actividades que los procedimientos de reparación abierta tradicionales.^1-4 Los instrumentos endoscópicos WishBone™ ofrecen una sensación táctil y una ergonomía mejoradas que facilitan el uso invertido y retrógrado con cualquier manos.
_Referencias
_{1. Matsumoto M, Hasegawa T, Ito M, et al. Incidence of complications associated with spinal endoscopic surgery: nationwide survey in 2007 by the Committee on Spinal Endoscopic Surgical Skill Qualification of Japanese Orthopaedic Association.}_{Orthop Sci}_{. 2010;15(1):92-96. doi:10.1007/s00776-009-1428-6}
_{2. Ahn Y, Oh HK, Kim H, Lee SH, Lee HN. Percutaneous endoscopic lumbar foraminotomy: an advanced surgical technique and clinical outcomes.}_Neurosurgery_{. 2014;75(2):124-133. doi:10.1227/NEU.0000000000000361}
_{3. Polikandriotis JA, Hudak EM, Perry MW. Minimally invasive surgery through endoscopic laminotomy and foraminotomy for the treatment of lumbar spinal stenosis.}_{J Orthop}_{. 2013;10(1):13-16. doi:10.1016/j.jor.2013.01.006}
_{4. Ruetten S, Komp M, Merk H, Godolias G. Use of newly developed instruments and endoscopes: Full-endoscopic resection of lumbar disc herniations via the interlaminar and lateral transforaminal approach.}_{J Neurosurg Spine}_{2007;6(6):521-530. doi:10.3171/spi.2007.6.6.2.}

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Columna vertebral

Discectomía endoscópica transforaminal

Un abordaje transforaminal o paraespinal permite acceder a hernias-laterales lejanas. El uso de un endoscopio específico para columna minimiza el daño a los tejidos blandos, lo que da como resultado menor dolor posoperatorio. ^1,2 Además, estudios demostraron que aproximadamente el 85 % de los pacientes sometidos a discectomía lumbar endoscópica retornaron a la actividad deportiva en tan solo 6 a 8 semanas.^3,4
_Referencias
_{1. Sairyo K, Matsuura T, Higashino K, et al. Percutaneous endoscopic lumbar discectomy for athletes.}_{J Spine}_{. 2013;S5(006):1-4. doi:10.4172/2165-7939.S5-006}
_{2. Sivakanthan S, Williams JR, Feroze AH, et al. Endoscopic spine surgery in athletes: case series and review of literature.}_{World Neurosurg}_{. 2021;145:702-707. doi:10.1016/j.wneu.2020.08.211}
_{3. Polikandriotis JA, Hudak EM, Perry MW. Minimally invasive surgery through endoscopic laminotomy and foraminotomy for the treatment of lumbar spinal stenosis.}_{J Orthop}_{. 2013;10(1):13-16. doi:10.1016/j.jor.2013.01.006}
_{4. Ruetten S, Komp M, Merk H, Godolias G. Use of newly developed instruments and endoscopes: Full-endoscopic resection of lumbar disc herniations via the interlaminar and lateral transforaminal approach.}_{J Neurosurg Spine}_{. 2007;6(6):521-530. doi:10.3171/spi.2007.6.6.2}

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Columna vertebral

Arthrex Graft Gun

The graft gun can be used to deliver even the most challenging bone grafts, such as fibers, chips, and autograft chunks. This device can be used for interbody fusions requiring bone graft both pre- and postimplantation, and a cartridge loading system allows for quick assembly and loading on the back table.

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Columna vertebral

Cervical Foraminotomy and Decompression

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.^1,2Additionally, 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.}_{J Clin Med}_{. 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.}_{Global Spine J}_{. 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.}_{World Neurosurg}_{. 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.}_{J Pers Med}_{. 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.}_Neurospine._{2020;17(Suppl 1):S74-S80. doi:10.14245/ns.2040166.083}

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Columna vertebral

Corte transversal de la rama medial

Un enfoque endoscópico del corte transversal del nervio de la rama medial puede aliviar el dolor causado por la artropatia facetaria. La combinación de la visualización 4K con técnicas mínimamente invasivas permite a los cirujanos ver y tratar la patología espinal manteniendo la precisión quirúrgica y reduciendo las complicaciones posoperatorias.^1-2
_Referencias
_{1. Lewandrowski KU, Ransom NA, Yeung A. Return to work and recovery time analysis after outpatient endoscopic lumbar transforaminal decompression surgery.}_{J Spine Surg}_{. 2020 Jan;6(Suppl 1):S100-S115. doi:10.21037/jss.2019.10.01}
_{2. Sivakanthan S, Williams JR, Feroze AH, et al. Endoscopic spine surgery in athletes: case series and review of literature.}_{World Neurosurg}_{. 2021;145:702-707. doi:10.1016/j.wneu.2020.08.211}

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Columna vertebral

Discectomía endoscópica interlaminar

Columna vertebral

Discectomía endoscópica transforaminal

Columna vertebral

Arthrex Graft Gun

Columna vertebral

Cervical Foraminotomy and Decompression

Columna vertebral

Corte transversal de la rama medial

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