Full percutaneous intraoperative neuromonitoring technique in remote thyroid surgery: Porcine model feasibility study.

BACKGROUND: In remote thyroid surgery, a reliable intraoperative neuromonitoring (IONM) procedure is an important tool for reducing injury to recurrent laryngeal nerve (RLN). This study proposes an alternative or adjunct technique for performing full percutaneous (PC) IONM and confirms its feasibility in animal experiments. METHODS: This prospective porcine model study enrolled four piglets with eight nerve sides. Evoked electromyography (EMG) was stimulated from PC ball-tip probe, and recorded from EMG endotracheal tube (ETT) and from PC paired long-needle electrodes on the perichondrium of the lateral aspect of thyroid cartilage. RESULTS: In all RLNs and vagus nerves, typical laryngeal EMG waveforms were successfully evoked by PC probe stimulation and recorded by both ETT and PC needle electrodes. CONCLUSIONS: This study confirms the feasibility of the full PC IONM techniques in porcine model. However, further clinical studies are needed to compare the practicality of different remote-access approaches for thyroid surgery.

Full Percutaneous Treatment of Degenerative Disc Disease with Intradiscal Lumbar Interbody Fusion and Posterior Stabilization: Preliminary Results.

PURPOSE: To report the preliminary results of a novel full percutaneous interbody fusion technique for the treatment of degenerative disc disease (DDD) resistant to conservative treatment with posterior stabilization with rods and screws and transforaminal placement of an 8-mm-width intradiscal cage. MATERIALS AND METHODS: A total of 79 patients with lumbar spine DDD resistant to medical therapy and/or spondylolisthesis up to grade 2 were treated. We performed preoperative X-rays, CT and MRI. The outcomes were assessed using the VAS score and the Oswestry Disability Index at a 1-, 6- and 12-month follow-up and also included X-rays to evaluate the correct bone fusion and the absence of complications. RESULTS: Mean operation time was 130 min, and mean postoperative time until hospital discharge was 2 days. Postoperative values for VAS scores and ODI improved significantly compared to preoperative data: Mean preprocedural VAS was 7.49 ± 0.69 and decreased at 12-month follow-up to 1.31 ± 0.72, and mean preprocedural ODI was 29.94 ± 1.67 and decreased at 12-month follow-up to 12.75 ± 1.44. No poor results were reported, and no postprocedural sequelae were observed. CONCLUSIONS: In our experience, this preliminary report shows a feasible and safe full percutaneous alternative procedure and represents a minimally invasive management of degenerative disc disease with low back pain resistant to medical therapy with or without lumbar spondylolisthesis up to grade 2.