Preoperative Design for the Posterolateral Approach in Full-Endoscopic Spine Surgery for the Treatment of L5/S1 Lumbar Disc Herniation
Objective Full-endoscopic spine surgery (FESS) is a relatively less invasive treatment for lumbar disc herniation (LDH). This study investigated the optimal operative route of the posterolateral approach (PLA) of FESS for the treatment of L5/S1 LDH. Methods Between June 2016 and November 2018, a tot...
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| Format: | Article |
| Language: | English |
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Korean Spinal Neurosurgery Society
2019-03-01
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| Series: | Neurospine |
| Subjects: | |
| Online Access: | http://www.e-neurospine.org/upload/pdf/ns-1836316-158.pdf |
| _version_ | 1827362002249449472 |
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| author | Muneyoshi Fujita Hirotaka Kawano Tomoaki Kitagawa Hiroki Iwai Yuichi Takano Hirohiko Inanami Hisashi Koga |
| author_facet | Muneyoshi Fujita Hirotaka Kawano Tomoaki Kitagawa Hiroki Iwai Yuichi Takano Hirohiko Inanami Hisashi Koga |
| author_sort | Muneyoshi Fujita |
| collection | DOAJ |
| description | Objective Full-endoscopic spine surgery (FESS) is a relatively less invasive treatment for lumbar disc herniation (LDH). This study investigated the optimal operative route of the posterolateral approach (PLA) of FESS for the treatment of L5/S1 LDH. Methods Between June 2016 and November 2018, a total of 21 patients with leg pain due to L5/S1 LDH underwent PLA of FESS. According to the partial removal of the superior articular process (SAP) of the L5/S1 facet joint (FJ), we categorized these patients into 2 groups. LDH type, anatomical configurations (FJ, sacral ala [SA], and iliac crest [IC]), the presence or absence of spondylolysis, operation time, and operative outcome were compared between these 2 groups. Results Although the anatomical configuration of the FJ was the most important factor for the necessity of SAP removal, the configuration of the SA and IC did not restrict endoscope insertion and subsequent LDH removal. Even in intracanal LDH, the removal of SAP was not absolutely required depending on the FJ configuration. Furthermore, the presence of spondylolysis was a factor associated with the unnecessity of SAP removal. Conclusion Detailed radiological examination of the FJ configuration is an important preoperative investigation to determine the optimal operative route for PLA of FESS. |
| first_indexed | 2024-03-08T07:18:38Z |
| format | Article |
| id | doaj.art-98241cc8ab7f47b0ba10f80fcd0336fe |
| institution | Directory Open Access Journal |
| issn | 2586-6583 2586-6591 |
| language | English |
| last_indexed | 2024-03-08T07:18:38Z |
| publishDate | 2019-03-01 |
| publisher | Korean Spinal Neurosurgery Society |
| record_format | Article |
| series | Neurospine |
| spelling | doaj.art-98241cc8ab7f47b0ba10f80fcd0336fe2024-02-03T00:10:55ZengKorean Spinal Neurosurgery SocietyNeurospine2586-65832586-65912019-03-0116110511210.14245/ns.1836316.158852Preoperative Design for the Posterolateral Approach in Full-Endoscopic Spine Surgery for the Treatment of L5/S1 Lumbar Disc HerniationMuneyoshi Fujita0Hirotaka Kawano1Tomoaki Kitagawa2Hiroki Iwai3Yuichi Takano4Hirohiko Inanami5Hisashi Koga6 Iwai FESS clinic, Tokyo, Japan Iwai FESS clinic, Tokyo, Japan Iwai FESS clinic, Tokyo, Japan Iwai FESS clinic, Tokyo, Japan Iwai FESS clinic, Tokyo, Japan Iwai FESS clinic, Tokyo, Japan Iwai FESS clinic, Tokyo, JapanObjective Full-endoscopic spine surgery (FESS) is a relatively less invasive treatment for lumbar disc herniation (LDH). This study investigated the optimal operative route of the posterolateral approach (PLA) of FESS for the treatment of L5/S1 LDH. Methods Between June 2016 and November 2018, a total of 21 patients with leg pain due to L5/S1 LDH underwent PLA of FESS. According to the partial removal of the superior articular process (SAP) of the L5/S1 facet joint (FJ), we categorized these patients into 2 groups. LDH type, anatomical configurations (FJ, sacral ala [SA], and iliac crest [IC]), the presence or absence of spondylolysis, operation time, and operative outcome were compared between these 2 groups. Results Although the anatomical configuration of the FJ was the most important factor for the necessity of SAP removal, the configuration of the SA and IC did not restrict endoscope insertion and subsequent LDH removal. Even in intracanal LDH, the removal of SAP was not absolutely required depending on the FJ configuration. Furthermore, the presence of spondylolysis was a factor associated with the unnecessity of SAP removal. Conclusion Detailed radiological examination of the FJ configuration is an important preoperative investigation to determine the optimal operative route for PLA of FESS.http://www.e-neurospine.org/upload/pdf/ns-1836316-158.pdfFull-endoscopic spine surgeryLumbar disc herniationPosterolateral approachThree-dimensional computed tomographyMinimally invasive |
| spellingShingle | Muneyoshi Fujita Hirotaka Kawano Tomoaki Kitagawa Hiroki Iwai Yuichi Takano Hirohiko Inanami Hisashi Koga Preoperative Design for the Posterolateral Approach in Full-Endoscopic Spine Surgery for the Treatment of L5/S1 Lumbar Disc Herniation Neurospine Full-endoscopic spine surgery Lumbar disc herniation Posterolateral approach Three-dimensional computed tomography Minimally invasive |
| title | Preoperative Design for the Posterolateral Approach in Full-Endoscopic Spine Surgery for the Treatment of L5/S1 Lumbar Disc Herniation |
| title_full | Preoperative Design for the Posterolateral Approach in Full-Endoscopic Spine Surgery for the Treatment of L5/S1 Lumbar Disc Herniation |
| title_fullStr | Preoperative Design for the Posterolateral Approach in Full-Endoscopic Spine Surgery for the Treatment of L5/S1 Lumbar Disc Herniation |
| title_full_unstemmed | Preoperative Design for the Posterolateral Approach in Full-Endoscopic Spine Surgery for the Treatment of L5/S1 Lumbar Disc Herniation |
| title_short | Preoperative Design for the Posterolateral Approach in Full-Endoscopic Spine Surgery for the Treatment of L5/S1 Lumbar Disc Herniation |
| title_sort | preoperative design for the posterolateral approach in full endoscopic spine surgery for the treatment of l5 s1 lumbar disc herniation |
| topic | Full-endoscopic spine surgery Lumbar disc herniation Posterolateral approach Three-dimensional computed tomography Minimally invasive |
| url | http://www.e-neurospine.org/upload/pdf/ns-1836316-158.pdf |
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