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

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

Uma abordagem transforaminal, ou paraespinhal, oferece a capacidade de alcançar hérnias de disco laterais distantes. O uso de um endoscópio específico para a coluna vertebral minimiza a ruptura de tecido mole, resultando em menos dor pósoperatória.1,2 Além disso, os estudos mostraram que aproximadamente 85% dos pacientes submetidos a discectomia endoscópica lombar voltaram à atividades físicas em cerca de 6 a 8 semanas.3,4
Referências
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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