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AR-S1342-025-310

Human

Spine

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Procedure

Essa é uma poderosa opção de abordagem para o tratamento de todos os tipos de hérnia de disco torácica, minimizando significativamente os danos colaterais, perda de sangue, dor pós-operatória, e a manipulação da medula espinhal.1-4 Essa é a única abordagem que oferece uma visão livre do canal torácico ventral sem ressecção óssea extensa, e sem necessidade de entrar na cavidade torácica.
Referência
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

Discectomia endoscópica torácica transforaminal

Child (D)

A abordagem endoscópica para discectomias interlaminares fornece o acesso minimamente invasivo a hérnias posteriores na coluna lombar inferior que podem ser difíceis de alcançar por meio de uma abordagem transforaminal. Além disso, a discectomia interlaminar resulta em menos lesão tecidual e muscular, recuperação acelerada e um retorno mais rápido às atividades do que os procedimentos abertos tradicionais.1–4 Os instrumentos endoscópicos WishBone™ apresentam uma sensação tátil superior e ergonomia aprimorada que facilitam o uso invertido e retrógrado com qualquer mão.
Referências
1. Matsumoto M, Hasegawa T, Ito M, et al. Incidence of complications associated with spinal endoscopic&nbsp;surgery: nationwide survey in 2007 by the Committee on Spinal Endoscopic Surgical Skill Qualification of&nbsp;Japanese&nbsp;Orthopaedic&nbsp;Association.&nbsp;Orthop&nbsp;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&nbsp;surgical technique and clinical outcomes. Neurosurgery. 2014;75(2):124-133.&nbsp;doi:10.1227/NEU.0000000000000361
3.&nbsp;Polikandriotis JA, Hudak EM, Perry MW. Minimally invasive surgery through endoscopic laminotomy and&nbsp;foraminotomy for the treatment of lumbar spinal stenosis. J Orthop. 2013;10(1):13-16.&nbsp;doi:10.1016/j.jor.2013.01.006
4. Ruetten&nbsp;S,&nbsp;Komp&nbsp;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&nbsp;Neurosurg Spine 2007;6(6):521-530. doi:10.3171/spi.2007.6.6.2.​

Discectomia endoscópica interlaminar

Endoscopic lateral recess decompression is an ultra-minimally invasive technique designed to relieve nerve pressure caused by a specific form of spinal stenosis, where the central canal remains open but the lateral recess compresses the traversing nerve root. This often-overlooked pathology is a common cause of unilateral or bilateral radiculopathy. By utilizing the interlaminar corridor, surgeons can precisely remove compressive bone and tissue with minimal disruption to surrounding anatomy. Patients typically experience significant pain relief and improved mobility shortly after surgery.1 Long-term studies suggest these benefits are durable, with low reoperation rates.2
 
References&nbsp;
 
1. Lee CH, Choi M, Ryu DS, et al. Efficacy and safety of full-endoscopic decompression via interlaminar approach for central or lateral recess spinal stenosis of the lumbar spine: a meta-analysis. Spine (Phila Pa 1976). 2018;43(24):1756-1764. doi:10.1097/BRS.0000000000002708. Erratum: Spine (Phila Pa 1976). 2019;44(4):E258. doi:10.1097/BRS.0000000000002988
 
2. Kesornsak W, Kuansongtham V, Lwin KMM, Pongpirul K. Pain improvement and reoperation rate after full-endoscopic decompression for lateral recess stenosis: a 10-year follow-up. Eur Spine J. 2023;32(8):2882-2888. doi:10.1007/s00586-023-07801-6

Lateral Recess Decompression

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

Uma abordagem endoscópica para a transecção do nervo do ramo medial pode levar ao alívio da dor causada pela artropatia da articulação facetária. A combinação da visualização 4K com técnicas minimamente invasivas permite que os cirurgiões visualizem e tratem a patologia da coluna vertebral mantendo a precisão cirúrgica e reduzindo as complicações pós-operatórias.1,2
Referências
1. Lewandrowski&nbsp;KU, Ransom NA, Yeung A. Return to work and recovery time analysis after&nbsp;outpatient endoscopic lumbar transforaminal decompression surgery. J Spine Surg. 2020&nbsp;Jan;6(Suppl 1):S100-S115. doi:10.21037/jss.2019.10.01
2. Sivakanthan&nbsp;S, Williams JR,&nbsp;Feroze&nbsp;AH, et al. Endoscopic spine surgery in athletes: case series&nbsp;and review of literature. World&nbsp;Neurosurg. 2021;145:702-707.&nbsp;doi:10.1016/j.wneu.2020.08.211​

Transecção do ramo medial

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

Discectomia endoscópica transforaminal

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

Blunt Dissector, 2.5 x 310mm

AR-S1342-025-310

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