Trans-foraminal endoscopic uniportal decompression in degenerative lumbar spondylolisthesis: a technical and case report
Abstract Background Degenerative spondylolisthesis is a common spinal pathology. Traditionally, spinal fusion is an accepted standard surgical treatment for listhesis. But fusion is a major intervention with its known pitfalls. With technological progression, minimally invasive spinal fusion (MISF)...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2019-10-01
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| Series: | Egyptian Journal of Neurosurgery |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s41984-019-0065-4 |
| _version_ | 1819173116618735616 |
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| author | Ajay Krishnan Mahesh Kulkarni Mreetaunjay Singh Chaitanya Reddy Shivanand Mayi D. Devanand Ravi Ranjan Rai Bharat R. Dave |
| author_facet | Ajay Krishnan Mahesh Kulkarni Mreetaunjay Singh Chaitanya Reddy Shivanand Mayi D. Devanand Ravi Ranjan Rai Bharat R. Dave |
| author_sort | Ajay Krishnan |
| collection | DOAJ |
| description | Abstract Background Degenerative spondylolisthesis is a common spinal pathology. Traditionally, spinal fusion is an accepted standard surgical treatment for listhesis. But fusion is a major intervention with its known pitfalls. With technological progression, minimally invasive spinal fusion (MISF) procedures are becoming mainstream. Percutaneous trans-foraminal endoscopic lumbar discectomy/decompressions (PTELD) without stabilization has many advantages over even a MISF for select group of patients. Case presentation In this case report, we describe using a uniportal unilateral trans-foraminal approach (TFA) for stable listhesis with lumbar disc herniation (LDH) causing chronic bilateral radicular symptoms and back pain with acute exacerbation. Under local anesthesia, we used a flat entry for PTELD, which facilitates an approach to both disc sides ventrally and even dorsal aspect lateral recess decompression on the dominant ipsilateral side. No fixation was done. An excellent outcome is obtained immediately at 6 weeks and maintained at 39 months of follow-up. Conclusion PTELD is worth considering as an intermediate procedure before fusion is offered in lateral recess stenosis in stable listhesis patients who have consented and understand the progressive cascade of spinal degeneration. |
| first_indexed | 2024-12-22T20:17:58Z |
| format | Article |
| id | doaj.art-c71f906166944c1594654fcebb6db9d7 |
| institution | Directory Open Access Journal |
| issn | 2520-8225 |
| language | English |
| last_indexed | 2024-12-22T20:17:58Z |
| publishDate | 2019-10-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Egyptian Journal of Neurosurgery |
| spelling | doaj.art-c71f906166944c1594654fcebb6db9d72022-12-21T18:13:56ZengSpringerOpenEgyptian Journal of Neurosurgery2520-82252019-10-013411710.1186/s41984-019-0065-4Trans-foraminal endoscopic uniportal decompression in degenerative lumbar spondylolisthesis: a technical and case reportAjay Krishnan0Mahesh Kulkarni1Mreetaunjay Singh2Chaitanya Reddy3Shivanand Mayi4D. Devanand5Ravi Ranjan Rai6Bharat R. Dave7Stavya Spine Hospital & Research InstituteStavya Spine Hospital & Research InstituteStavya Spine Hospital & Research InstituteStavya Spine Hospital & Research InstituteStavya Spine Hospital & Research InstituteStavya Spine Hospital & Research InstituteStavya Spine Hospital & Research InstituteStavya Spine Hospital & Research InstituteAbstract Background Degenerative spondylolisthesis is a common spinal pathology. Traditionally, spinal fusion is an accepted standard surgical treatment for listhesis. But fusion is a major intervention with its known pitfalls. With technological progression, minimally invasive spinal fusion (MISF) procedures are becoming mainstream. Percutaneous trans-foraminal endoscopic lumbar discectomy/decompressions (PTELD) without stabilization has many advantages over even a MISF for select group of patients. Case presentation In this case report, we describe using a uniportal unilateral trans-foraminal approach (TFA) for stable listhesis with lumbar disc herniation (LDH) causing chronic bilateral radicular symptoms and back pain with acute exacerbation. Under local anesthesia, we used a flat entry for PTELD, which facilitates an approach to both disc sides ventrally and even dorsal aspect lateral recess decompression on the dominant ipsilateral side. No fixation was done. An excellent outcome is obtained immediately at 6 weeks and maintained at 39 months of follow-up. Conclusion PTELD is worth considering as an intermediate procedure before fusion is offered in lateral recess stenosis in stable listhesis patients who have consented and understand the progressive cascade of spinal degeneration.http://link.springer.com/article/10.1186/s41984-019-0065-4LumbarDiscHerniationStenosisVentralTrans-foraminal |
| spellingShingle | Ajay Krishnan Mahesh Kulkarni Mreetaunjay Singh Chaitanya Reddy Shivanand Mayi D. Devanand Ravi Ranjan Rai Bharat R. Dave Trans-foraminal endoscopic uniportal decompression in degenerative lumbar spondylolisthesis: a technical and case report Egyptian Journal of Neurosurgery Lumbar Disc Herniation Stenosis Ventral Trans-foraminal |
| title | Trans-foraminal endoscopic uniportal decompression in degenerative lumbar spondylolisthesis: a technical and case report |
| title_full | Trans-foraminal endoscopic uniportal decompression in degenerative lumbar spondylolisthesis: a technical and case report |
| title_fullStr | Trans-foraminal endoscopic uniportal decompression in degenerative lumbar spondylolisthesis: a technical and case report |
| title_full_unstemmed | Trans-foraminal endoscopic uniportal decompression in degenerative lumbar spondylolisthesis: a technical and case report |
| title_short | Trans-foraminal endoscopic uniportal decompression in degenerative lumbar spondylolisthesis: a technical and case report |
| title_sort | trans foraminal endoscopic uniportal decompression in degenerative lumbar spondylolisthesis a technical and case report |
| topic | Lumbar Disc Herniation Stenosis Ventral Trans-foraminal |
| url | http://link.springer.com/article/10.1186/s41984-019-0065-4 |
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