RESUMEN
Transforaminal endoscopic spine surgery (T-ESS) has become a well-accepted technique. The first attempts at percutaneous discectomy by Kambin and Hijikata opened a new chapter of endoscopic spine surgery. By the last quarter of the twentieth century, spine surgeons had begun to adopt this novel technique. Many researchers helped advance endoscopic spine surgery, but the turning point was the description of a safe transforaminal triangle of safety by Parviz Kambin. Since then, the indications for T-ESS have increased as a result of the description of different surgical approaches such as inside-out, outside-in, and half-and-half. We present a review of crucial historical advancements in T-ESS and also discuss the evolution of endoscopes, the techniques used, development of endoscopic instruments and equipment, transforaminal thoracic endoscopy, transforaminal endoscopic interbody fusions, the growth of extended indications, and the future direction of T-ESS. This review provides a detailed description of key historical moments and a bird's-eye view of the vast scope of T-ESS.
Asunto(s)
Procedimientos Quirúrgicos Mínimamente Invasivos/tendencias , Neuroendoscopios/tendencias , Neuroendoscopía/tendencias , Enfermedades de la Columna Vertebral/cirugía , Discectomía Percutánea/métodos , Discectomía Percutánea/tendencias , Humanos , Degeneración del Disco Intervertebral/diagnóstico por imagen , Degeneración del Disco Intervertebral/cirugía , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Neuroendoscopía/métodos , Enfermedades de la Columna Vertebral/diagnóstico por imagenRESUMEN
BACKGROUND: Schmorls node (SN) are mostly asymptomatic and incidental findings on MRI. However, sometimes they present like acute onset low back pain or acute exacerbation of chronic back pain after minor trauma. CASE PRESENTATION: We present rare case of symptomatic infected SN in 67 years female patient presented with complains of low back pain radiating to right buttock. After initial conservative treatment failed subsequent imaging showed significant increase in size of lesion with focal signal changes in disc space gave suspicion of underlying secondary pathology. Patient operated for complete excision of lesion. Histopathological report was suggestive of pyogenic vertebral osteomyelitis. Patient improved well postoperatively. CONCLUSION: Most of the time acute SN responds well to conservative treatment; however rapid deterioration of symptoms or persistent severe pain should give suspicion of underlying secondary pathology.
Asunto(s)
Degeneración del Disco Intervertebral/patología , Desplazamiento del Disco Intervertebral/patología , Dolor de la Región Lumbar/etiología , Imagen por Resonancia Magnética/métodos , Osteomielitis/diagnóstico , Administración Intravenosa , Cuidados Posteriores , Anciano , Aminoglicósidos/administración & dosificación , Aminoglicósidos/uso terapéutico , Antibacterianos/administración & dosificación , Antibacterianos/uso terapéutico , Cefalosporinas/administración & dosificación , Cefalosporinas/uso terapéutico , Quimioterapia Combinada , Femenino , Humanos , Degeneración del Disco Intervertebral/diagnóstico por imagen , Degeneración del Disco Intervertebral/cirugía , Desplazamiento del Disco Intervertebral/diagnóstico por imagen , Desplazamiento del Disco Intervertebral/cirugía , Dolor de la Región Lumbar/diagnóstico , Vértebras Lumbares/patología , Vértebras Lumbares/cirugía , Osteomielitis/tratamiento farmacológico , Resultado del TratamientoRESUMEN
BACKGROUND: Transforaminal endoscopic surgery provides equivalent results to open surgery with added advantages of feasibility under local anesthesia, no injury to posterior elements, preservation of the ligamentum flavum, ease of revision surgery, and cost-effectiveness. The technique of transforaminal endoscopic excision of cysts of facet or zygapophyseal joints is scarcely described in literature. METHODS: The transforaminal endoscopy is applicable to cyst lying in the extraforaminal, foraminal, and intraspinal regions. The "mobile" outside-in technique combined with osteotomy of the tip of the superior articular process facilitates intraspinal access for complete decompression. CONCLUSION: Transforaminal endoscopic removal of the facet cyst is a viable alternative to traditional open surgery with added advantages of a minimal access procedure.