Finished Product

AR-S3350-7030-181

Human

Spine

Product

Procedure

Dural tears are a common concern during traditional open or mini-open spine surgery, with studies showing as high as a 10% occurrence rate during lumbar stenosis procedures.1-4 This page provides information and solutions for the management of incidental durotomies during endoscopic procedures.
References
1. Nielsen TH, Rasmussen MM, Thygesen MM. Incidence and risk factors for incidental durotomy in spine surgery for lumbar stenosis and herniated disc. Acta Neurochir (Wien). 2022;164(7):1883-1888.
2. Greil ME, Bergquist J, Kashlan ON, Kwon WK, Durfy S, Hofstetter CP. Incidence and management of dural tears in full-endoscopic unilateral laminotomies for bilateral lumbar decompression.&nbsp;Eur Spine J. 2023;32(8):2889-2895. doi:10.1007/s00586-023-07749-7
3. Lewandrowski KU, Hellinger S, De Carvalho PST, et al. Dural tears during lumbar spinal endoscopy: surgeon skill, training, incidence, risk factors, and managment.&nbsp;Int J Spine Surg. 2021;15(2):280-294. doi:10.14444/8038
4. Trathitephun W, Asawasaksakul A, Jaruwanneechai K, et al. Intraoperative management of iatrogenic durotomy in endoscopic spine surgery: a systematic review.&nbsp;Neurospine. 2024;21(3):756-766. doi:10.14245/ns.2448346.173

Dural Repair

Child (D)

The traditional open approach for treating far lateral disc herniations at L5-S1 is challenging. Alternatively, the transforaminal endoscopic approach lands directly at the far lateral zone and requires little or no facet resection to achieve decompression.

Far Lateral Transforaminal Endoscopic Lumbar Discectomy

A transforaminal, or paraspinal, approach provides the ability to reach far-lateral disc herniations. Using a spine-specific endoscope minimizes soft-tissue disruption, resulting in less postoperative pain.1,2 Additionally, studies showed that approximately 85% patients who underwent endoscopic lumbar discectomy returned to athletic activity in as few as 6 to 8 weeks.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

Spine Endoscope, 7 mm × 181 mm, 30°

AR-S3350-7030-181

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